急性脑卒中患者的功能特点与早期康复干预的标准

目的：探讨急性脑卒中功能障碍的特点，确定早期康复治疗干预的标准和临床运用的可行性。方法：对125例急性脑卒中患者的主要表现和缺损进行检查和记录，采用Glasgow昏迷量表、简明精神状态检查（MMSE）、简式Fugl-Meyer量表、Barthel指数、焦虑抑郁联合评定量表等进行评定。早期康复干预标准为：患者生命体征稳定，神经学症状不再发展后48h，GCS＞8。对和量表评定的资料进行统计分析。结果：全部病例有93．6％符合早期康复干扰的标准，存在运动、感觉、认知、言语、吞咽和情绪等方面缺陷的表现，大多数患者临床神经功能缺损程度、简式Fugl-Meyer量表、Barthel指数评分显示重度障碍，近半数患者MMSE评分显示痴呆。结论：急性脑卒中患者早期以功能性运动和日常生活自理功能障碍为主，合并多种残疾为特点，医疗康复残疾水平处在完全依赖的状态。临床以患者生命体征稳定，神经学症状不再发展后48h，GCS＞8为早期康复干预的指征是可行的。

Functional characteristics of patients in acute stroke and criteria of early stage intervention

Objective To study the functional characteristics and confirm criteria and clinic feasibility of early stage intervention. Methods The defects of 125 patients in acute stroke were examined and recorded. Glasgow Coma Scale, Mini-Mental Status Examination, Fugl-Meyer Assessment, Modified Barthel Index, Hospital Anxiety and Depression Scale were adopted in evaluation. The criteria of early stage intervention was that the life sign of the patient was stabilized, 48 h after neurology symptom was not progressed, GCS>8. The data of clinic and functional evaluation were analysis statistically. Results There were 93. 6% patients conformed to the criteria of early stage intervention of acute stroke, who afflicted with disorders of movement, sense, cognition, speech, swallow and emotion. Most of them showed serious disorder in Clinical Nerve Function Defect Level, Brief Fugl-Meyer Assessment, Barthel Index. Almost half patients showed dementia in MMSE. Conclusions The patients of acute stroke in early stage have the evident disability on functional movement and ADL, and incorporate other impairment. They are entirely dependent. It is feasible, that the criteria of early stage intervention is that the life sign of the patient is stabilized, 48 h after neurology symptom is not progressed, and GCS>8.