中国神经再生研究(英文版) ›› 2016, Vol. 11 ›› Issue (11): 1766-1772.doi: 10.4103/1673-5374.194746

• 原著:脑损伤修复保护与再生 • 上一篇    下一篇

系统康复干预能有效改善青年卒中患者神经功能

  

  • 收稿日期:2016-02-06 出版日期:2016-11-30 发布日期:2016-11-30
  • 基金资助:

    中央级公益性科研院所基本科研业务费专项资金(课题号:2014CZ-13)

Effects of professional rehabilitation training on the recovery of neurological function in young stroke patients

Chao-jin-zi Li1, 2, Xiao-xia Du1, 2, *, Kun Yang3, Lu-ping Song1, 2, Peng-kun Li1, 4, Qiang Wang1, 2, Rong Sun1, 2, Xiao-ling Lin1, Hong-yu Lu1, Tong Zhang1, 2   

  1. "1 School of Rehabilitation Medicine, Capital Medical University, Beijing, China 2 Department of Neurological Rehabilitation, Beijing Bo’ai Hospital, China Rehabilitation Research Center, Beijing, China 3 Department of Neurology, Xi’an Gaoxin Hospital, Xi’an, Shaanxi Province, China 4 Room of Medical Records, Beijing Bo’ai Hospital, China Rehabilitation Research Center, Beijing, China"
  • Received:2016-02-06 Online:2016-11-30 Published:2016-11-30
  • Contact: Xiao-xia Du, M.D., 364906784@qq.com.
  • Supported by:

    This research was supported by the Special Fund of Basic Scientifc Research Service Fee of Central Public Welfare Scientifc Research Institute of China, No. 2014CZ-13.

摘要:

虽然青年脑卒中患者回归社会需求更为迫切,但目前关于青年脑卒中患者的康复治疗项目、强度及预后的研究较少。为此我们对2014年2月至2015年5月在中国首都医科大学中国康复研究中心神经康复科住院的青年脑卒中及中老年脑卒中患者的临床资料进行回顾性分析,结果发现青年组患者以出血性脑卒中(59.6%)为主,而中老年组患者则以缺血性脑卒中(60.0%)为主。与中老年脑卒中患者相比,青年脑卒中患者受教育程度高、伴高同型半胱氨酸血症发病率者更高,伴高血压、糖尿病、心脏病等发病率低于老年脑卒中患者,平均住院天数更长;青年脑卒中患者发病的主要危险因素依次为高血压、饮酒、吸烟、高脂血症、高同型半胱氨酸血症、糖尿病、既往脑卒中病史、心脏病;接受最多的康复训练项目为物理疗法、作业疗法、言语疗法、针灸等,平均专业化康复训练时间为2.5h/d;出院时巴氏指数及mRS分数提高,出院6个月时对职业、经济水平的满意度下降,对家庭生活满意度无变化,其他生活满意度(如朋友的关系满意度等)均提升,青年脑卒中患者经过系统康复干预后虽然残疾程度及功能状态明显改善,但发病6个月后回归社会的患者数量仍较少。

 orcid: 0000-0001-7944-2474 (Xiao-xia Du)

关键词: 神经再生, 青年脑卒中, 危险因素, 神经功能恢复, 预后评估, 生活满意度量表, 巴氏指数, 改良Rank量表

Abstract:

Young stroke patients have a strong desire to return to the society, but few studies have been conducted on their rehabilitation training items, intensity, and prognosis. We analyzed clinical data of young and middle-aged/older stroke patients hospitalized in the Department of Neurological Rehabilitation, China Rehabilitation Research Center, Capital Medical University, China from February 2014 to May 2015. Results demonstrated that hemorrhagic stroke (59.6%) was the primary stroke type found in the young group, while ischemic stroke (60.0%) was the main type detected in the middle-aged/older group. Compared with older stroke patients, education level and incidence of hyperhomocysteinemia were higher in younger stroke patients, whereas, incidences of hypertension, diabetes, and heart disease were lower. Te average length of hospital stay was longer in the young group than in the middle-aged/older group. Te main risk factors observed in the young stroke patients were hypertension, drinking, smoking, hyperlipidemia, hyperhomocysteinemia, diabetes, previous history of stroke, and heart disease. Te most accepted rehabilitation program consisted of physiotherapy, occupational therapy, speech therapy, acupuncture and moxibustion. Average rehabilitation training time was 2.5 hours/day. Barthel Index and modifed Rankin Scale scores were increased at discharge. Six months afer discharge, the degree of occupational and economic satisfaction declined, and there were no changes in family life satisfaction. Te degrees of other life satisfaction (such as friendship) improved. Te degree of disability and functional status improved signifcantly in young stroke patients afer professional rehabilitation, but the number of patients who returned to society within 6 months afer stroke was still small.

Key words: nerve regeneration, young stroke patients, risk factors, recovery of neurological function, prognosis, Life Satisfaction Questionnaire, Barthel Index, modifed Rank Scale, neural regeneration