運用巴氏量表於出血性腦中風患者復健治療三個月成效追蹤

A Three Month Follow-up Study of Hemorrhagic Stroke Patients Receiving Rehabilitation Therapy as Assessed by the Barthel Index

腦中風為腦部血流供應受阻所造成，積極地手術與復健治療出血性腦中風可降低腦部損傷，達到較好的功能性恢復。本研究目的為運用巴氏量表評估出血性腦中風復健治療後一個月與三個月功能恢復。本研究之22位對象年齡介於19至86歲間，係來自於台灣某醫學中心，診斷為出血性腦中風並且接受手術治療者。以巴氏量表評估研究對象於手術後三天、復健治療後一個月及三個月之功能性結果。研究結果發現：復健治療成效與癱瘓程度呈顯著相關（p=0.000）。在復健治療後一個月，4.5%的研究對象巴氏量表可達到100分，顯示可以完全獨立。復健治療後三個月，9%研究對象巴氏量表分數達到100分。本研究對象之功能性恢復項目中，以Wilcoxon Signed rank test統計分析發現進食、輪椅與床的移位、個人衛生、行走於平地上及上下樓梯五項目具顯著差異（p<0.05）。在洗澡項目未有顯著改善（0.68至0.91）。研究發現經手術治療與復健治療，出血性腦中風患者可達到完全性獨立。因此，巴氏量表有助於評估病患接受持續性的復健治療時功能恢復狀況，特別是進食、輪椅與床的移位、個人衛生、行走於平地上及上下樓梯等五項。

Stroke is a disruption in the cerebrovascular blood supply. Aggressive surgical and rehabilitation therapy with hemorrhagic stroke could achieve functional recovery in an attempt to minimize brain damage. The purpose of this study was to assess hemorrhagic stroke patients with functional recovery using the Barthel Index (BI) on the third day after surgery, and the first and third months after rehabilitation therapy. Twenty-two stroke patients were selected from a medical center. Subjects were 19 to 86 years of age, were diagnosed with hemorrhagic stroke, and underwent craniotomy surgery. The BI was used to assess the subject's functional outcome the third day after craniotomy surgery, and after the first and third months of rehabilitation therapy. The effect of rehabilitation therapy on paralysis was significant (p=0.000). In the first month after rehabilitation, 4.5% of subjects achieved a BI score of 100, indicating complete independence. In the third month after rehabilitation, 9% of subjects achieved a BI score of 100. Based on analysis with the Wilcoxon signed rank test, each item of the BI, such as feeding, grooming, transfer, ambulation, and stair-climbing, were improved significantly (p＜0.05); the subjects did not improve on bathing according to the BI (0.68 to 0.91). This study found that hemorrhagic stroke patients could be completely independent after craniotomy surgery and rehabilitation therapy. Therefore, the aforementioned items of the BI might help assess the functional recovery of these patients receiving continuous rehabilitation therapy.