Using Quantitative CT To Evaluate The Effects Of Three-stage Rehabilitation Treatment To Bone And Muscle Of The Patients With Acute Cerebral Apoplexy

Purpose: this paper uses quantitative CT as follow-up method to evaluate the effects of three-stage rehabilitation treatment to delay rarefaction of bone and muscle atrophy of the patients with acute cerebral apoplexy.Method: this paper collected the data about patients with acute cerebral apoplexy who were in hospital for the first attack in The Affiliated Hospital of Guizhou Medical University,and remove the patients with defective hepatorenal functions,congestive heart failure,respiratory function failure,active liver disease,malignant tumor,malignant hypertension and poor control and the patients who had cognition impairment and couldn’t coordinate the treatment,and the patients who were too far to make follow-up with,had alzheimer’s disease,mental disease and deaf patients.This paper divides them for two groups,each group 10 patients and they are respectively for Experimental Group and Control Group.The Experimental Group accepts three-stage rehabilitation treatment and Control Group never accepts any systematic rehabilitation treatment.The methods of rehabilitation treatment are as follows: 1.The location of normal limb position;2.Training of joint range of motion;3.Self positive and passive movement;4.Action transfer training;5.Basic daily training activities;6.Training to inhibit trunk and limb spasm;7.Function training of upper limb;8.Balance training;9.Positive movement of lower limb and training induced by separatist movement;10.Step training;11.Training of enhancing the daily life ability;12.Orthosis;13.Environmental reform.The QCT measuring methods are as follows: before the treatment,the end of three months after treatment and the end of six months after treatment,adopts SIEMENS128 SOMATOM Definition AS+Spiral CT scanner to scan lumbar vertebra(L1-3),neck of femur and the muscle of middle thigh.Upload to QCT post-processing software(QCT Pro)to measure the cross sectional area of lumbar vertebra at three timing(L1-3),the bone mineral density of neck of femur and the muscle of middle thigh.Statistical method: adopt EXCEL and SPSS 21.0 statistical software to make data handing and statistic analysis to all the data,adopt sx ?to express the measurement data.And use variance analysis to repeated measure data to compare with the information at different times.Use Wilcoxon rank sum test for ranked data.The inspection level statistically is α<0.05,and the significance level is P < 0.05.Results:(1)comparison before and after treatment: the comparison on cross sectional areas of lumbar vertebra at three timing(L1-3),the bone mineral density of neck of femur and the muscle of middle thigh before and after treatment has statistical significance(P<0.05);(2)comparison on the groups of lumbar vertebra: comparison on the BMD values between two groupshave statistical significance(P<0.05);(3)comparison on the groups of neck of femur:the comparison on BMD values of hemiplegia between two groups have statistical significance(P<0.05);and the comparison on values of uninjured side have no statistical significance(P>0.05);(4)comparison on inner side and affected side of neck of femur: there are no statistical significance between the in Experimental Group(P>0.05);and for Control Group,there are statistical significance(P<0.05);(5)comparison on cross sectional area of middle thigh between two groups: the comparison on the cross section area of hemiplegia side and uninjured side of middle thigh have no statistical significance(P>0.05);(6)comparison on inner side and injured side of cross sectional area of middle thigh: there are no statistical significance for the comparison on inner side and injured side in Experimental group(P>0.05),and the comparison in Control Group has statistical significance(P<0.05);Conclusion:(1)the three-stage rehabilitation treatment can delay the speed of reduction of limb structure and it is necessary to make early-term treatment to the patients with cerebral apoplexy and hemiparesis and full-course treatment.(2)During the rehabilitation process,it is required to make necessary imageological examination to supervise the changes of limb structure and prevent the complications caused by reduction of limb structure.