刘英华 邹丽芸 曹玉萍

【摘要】 目的：探討良肢位摆放联合下肢功能锻炼仪在高血压脑出血偏瘫患者下肢功能恢复中的应用效果。方法：选取2018年9月-2019年6月本院收治的50例高血压脑出血偏瘫患者作为对照组，另选取2019年7月-2020年1月本院收治的50例高血压脑出血偏瘫患者作为试验组。对照组予以常规体位护理及康复锻炼，试验组予以早期进行良肢位摆放联合下肢功能锻炼仪进行锻炼。采用Fugl-meyer 运动功能积分法（FMA）评价并比较两组肢体功能;采用改良Barthel指数评价并比较两组日常生活活动能力;采用生活质量综合评定量表（GQOLI-74）评价并比较两组生活质量。结果：治疗后，两组FMA中上肢、下肢运动功能、关节活动度评分均高于治疗前，且试验组均高于对照组（P<0.05）。治疗后，两组改良Barthel指数均高于治疗前，且试验组高于对照组（P<0.05）。治疗后，两组GQOLI-74各项评分均高于治疗前，且试验组均高于对照组（P<0.05）。结论：高血压脑出血偏瘫患者应用良肢位摆放联合下肢功能锻炼仪，可改善肢体运动功能、日常生活活动能力及生活质量，值得临床使用。

【关键词】 高血压脑出血偏瘫 良肢位 下肢功能锻炼仪 下肢功能恢复

Application of Good Limb Position Placement Combined with Lower Limb Function Exercise Instrument in Lower Limb Function Recovery of Patients with Hypertensive Cerebral Hemorrhage Hemiplegia/LIU Yinghua， ZOU Liyun， CAO Yuping. //Medical Innovation of China， 2021， 18（01）： 0-096

[Abstract] Objective： To explore the application effect of good limb position placement combined with lower limb functional exercise instrument in lower limb function recovery of patients with hypertensive cerebral hemorrhage hemiplegia. Method： A total of 50 patients with hypertensive cerebral hemorrhage hemiplegia admitted to our hospital from September 2018 to June 2019 were selected as the control group， and 50 patients with hypertensive cerebral hemorrhage hemiplegia admitted to our hospital from July 2019 to January 2020 were selected as the experimental group. The control group was given routine body position nursing and rehabilitation exercises， while the experimental group was given good limb position placement in the early stage combined with lower limb functional exercise instrument for exercise. The limb functions of two groups were evaluated and compared by Fugl-meyer motor function integral method （FMA）. The daily living activities of two groups were evaluated and compared by improved Barthel index. The quality of life of two groups were evaluated and compared by the comprehensive quality of life rating scale （GQOLI-74）. Result： After treatment， upper limbs， lower limbs motor functions and joint range scores of FMA in both groups were higher than those before treatment， and the experimental group were higher than those of the control group （P<0.05）. After treatment， the improved Barthel index in both groups were higher than those before treatment， and that in the experimental group was higher than the control group （P<0.05）. After treatment， all scores of GQOLI-74 in both groups were higher than those before treatment， and those in the experimental group were higher than those in the control group （P<0.05）. Conclusion： The application of good limb position placement combined with lower limb function exercise instrument can improve limb motor function， activities of daily living and quality of life in patients with hypertensive cerebral hemorrhage hemiplegia.

[Key words] Hypertensive cerebral hemorrhage hemiplegia Good limb position Lower extremity functional exercise instrument Lower limb function recovery

First-authors address： Jingdezhen Second Peoples Hospital， Jingdezhen 333000， China

doi：10.3969/j.issn.1674-4985.2021.01.024

高血压脑出血由于发病时脑组织受到压迫造成神经细胞水肿，缺血坏死，常会给患者留有包括瘫痪、肢体功能障碍甚至精神障碍等后遗症。部分患者运动区受损，术后偏瘫风险增加，对预后及日后生活质量有较大影响[1-2]。脑出血患者术后康复对于患者运动能力的恢复具有重要作用，良肢位是早期抗痉挛、保护关节及早期诱发分离运动而设计的一种重要措施，可防止压疮、肺部感染、泌尿系统感染、肩关节脱位、肩手综合征等的方式[3]。下肢功能锻炼仪是一种下肢功能康复锻炼器，可被动或主动活动下肢，促进血液循环，防止下肢血栓形成，通过设置的U型卡板卡在床尾护栏上并用卡板固定旋钮螺栓锁固，使得下肢锻炼器稳定不会晃动，减少患者锻炼时的受伤风险，可提高患者肢体肌力，关节活动度等[4]。……