脑卒中后上肢运动功能的影响因素研究

Analysis of Influencing Factors on Upper Limb Motor Function in Stroke

摘要: 目的：探讨脑卒中患者上肢运动功能恢复的可能影响因素，为卒中后患者上肢运动功能康复预后提供参考依据。方法：选取2021年8月至2023年8月期间收治在安徽医科大学第一附属医院康复医学科199例患脑卒中患者，根据Brunnstrom分期分为预后不良组(n = 111例)和预后良好组(n = 88例)。对两组患者的临床资料进行回顾分析，对基本情况和此次发病情况进行统计和比较，并使用logistic回归进行多因素分析。结果：预后不良组患者白蛋白水平明显低于预后良好组(P < 0.05)；预后不良组合并肺部感染、认知功能障碍、失语症和吞咽功能障碍的患者明显多于预后良好组(P < 0.05)。经过logistic回归分析，白蛋白、认知功能障碍及吞咽功能障碍是脑卒中患者上肢运动功能恢复的影响因素。结论：脑卒中患者白蛋白水平低、合并认知功能障碍或吞咽功能障碍会对上肢运动功能的恢复造成不良影响。

Abstract: Objective: To explore the influencing factors that may affect the prognosis of upper limb motor function in post-stroke patients and provide a reference for upper limb functional rehabilitation in stroke patients. Methods: 199 stroke patients admitted to the Department of Rehabilitation Medi-cine of the First Affiliated Hospital of Anhui Medical University from August 2021 to August 2023 were selected and divided into poor prognosis group (n = 111 cases) and good prognosis group (n = 88) according to Brunnstrom staging. The clinical data of the two groups of patients were retrospec-tively analyzed, and the basic information and the incidence of the disease were statistically ana-lyzed and compared; logistic regression was used to conduct multi-factor analysis. Results: The al-bumin level of the patients in the poor prognosis group was significantly lower than that of the good prognosis group(P < 0.05); the number of patients with pulmonary infection, sleep disorder, cogni-tive dysfunction, aphasia and swallowing dysfunction in the poor prognosis group was significantly higher than that in the good prognosis group(P < 0.05). After logistic regression analysis, albumin level, cognitive dysfunction and swallowing dysfunction were factors affecting the recovery of upper limb motor function in stroke patients. Conclusion: Low albumin levels, cognitive dysfunction or swallowing dysfunction in stroke patients have adverse effects on the recovery of upper limb motor function.