脑出血和脑梗塞的住院医疗康复效益分析

Functional outcome of hemorrhagic and nonhemorrhagic stroke patients after rehabilitation

目的 :通过对脑卒中患者住院医疗康复效益的对比研究 ,探讨脑出血和脑梗塞的病理特征与功能恢复的关系及对预后的影响。方法 :用功能独立检查对 82例康复科住院的脑卒中患者进行测量 ,并计算康复效益 ,将脑出血和脑梗塞患者入院、出院值 ,住院期间获得值 ,以及康复效益进行配对分析。结果 :脑出血患者入院功能独立检查运动分、认知分、总分均较脑梗塞患者低 (P <0 .0 5 ) ,出院时各功能独立检查无显著性差异 ,脑出血患者住院期间功能独立检查改变值较脑梗塞患者明显增高 (P <0 .0 5 ) ,认知分康复效益脑出血患者较脑梗塞患者为高 (P <0 .0 5 )。结论 :脑出血和脑梗塞的康复效益和功能预后不同 。

Objective: To compare the functional outcome of hemorrhagic and nonhemorrhagic stroke patients after in patient rehabilitation and to investigate the differences in functional prognosis of them.Method:Functional independence measure (FIM) was used to measure 32 hemorrhagic and 50 nonhemorrhagic stroke patients. Admission FIM, discharge FIM, FIM gain, FIM efficiency, length of stay (LOS) were compared.Result:There were no differences in admission FIM cognition scores, discharge FIM, FIM motor and FIM total efficiency and LOS between two groups. The nonhemorrhagic group had significantly higher admission FIM motor scores and FIM total scores ( P <0.05). However, FIM gain and FIM cognition efficiency of hemorrhagic stroke patients were significantly higher than nonhemorrhagic stroke patients (P <0.05).Conclusion:Hemorrhgic and nonhemorrhagic stroke patients have different functional outcome. Therapy must accord with the characteristic of stroke pathology. Author′s address Dept. of Rehabili. Medicine,The First Affiliated Hospital, Sun Yat sen University of Medical Sciences, Guangzhou, 510080