急性/康复联合卒中单元对急性脑梗死患者日常生活活动能力的影响

Effects of Combined Acute/Rehabilitation Stroke Unite on Activities of Daily Living of Acute Cerebral Infarction Patients

目的探讨急性／康复联合卒中单元对急性脑梗死患者日常生活活动能力的影响。方法185例急性脑梗死患者，随机分入急性，慷复联合卒中单元和普通病房。分别在入院和出院时进行Barthel指数（Barthel index，Bl）、Fugl-Meyer运动功能评定（Fugl-Meyer assessment，FMA）和美国国立卫生研究院卒中量表（U.S.National Institutes of Health Stroke Scale，NIHSS）评价，BI在随访至6个月时第3次评价，并应用SPSS13.0进行结果分析。结果治疗后，卒中单元组在出院时和6个月随访时的引改善值均高于普通病房组（20±18 VS 12±16，P〈0.01；44±20 VS 26±17，P〈0.01）。6个月时，卒中单元组生活基本自理的比例显著高于普通病房组（75.63％ VS 53.19％，P=0.003），而重度障碍率则低于普通病房组（12.09％ VS 21.28％，P=0.044）。两组出院时运动功能和神经功能均有改善，但改善值卒中单元组更大（P〈0.01）。结论与普通病房相比，急性／康复联合卒中单元能提高患者的日常生活活动能力，降低致残率，提高生活质量，提高运动功能，减少神经功能缺损。

Objective To investigate the effects of combined acute/rehabilitation stroke unit on activities of daily living of acute cerebral infarction patients. Methods 185 acute cerebral infarction patients were divided randomly either into combined acute/ rehabilitation stroke unite（SU） or general word（GW） to receive treatment by random envelopes of SPSS 13.0 software. To assess Barthel Index（BI）, Fugl-Meyer assessment（FMA） and U.S. National Instituees of Health Stroke Scale（NIHSS） at the day of admission and discharge. The BI would be evaluated for third time at 6 months follow-up. All these data were analyzed with SPSS soft packs. Results After treatment, the mean gap scores between the day of admission and discharge were significantly higher in SU（20±18） than in GW（12±16）（P=0.003）, meanwhile the mean gap scores between the day of admission and 6 months follow-up were also significantly higher in SU than in GW（SU 44±20, GW 26±17, P=0.000）. After 6 months, there were statistical difference between SU and GW in the rate of good ADL（BI〉60, GW 73.63%, SU 53.19%, P=0.003） and in the rate of serious handicap（BI〈40, GW 12.09%, SU 21.28%, P=0.044）. The mean gap scores between the day of admission and discharge demonstrated significant difference in BI（P=0.000） and in NIHSS（P=0.000）. Conclusion In comparison with that of GW, SU is able to restore the activities of daily living of acute cerebral infarction patients, alleviate the handicap grade, improve motor functions, and reduce neurological defects.