影响脑出血患者出院时日常生活活动能力的相关因素分析

Factors influencing the recovery of ability in the activities of daily living after cerebral hemorrhage

目的本研究通过对108例脑出血患者康复情况进行分析，探讨影响脑出血患者出院时日常生活活动能力的相关因素。方法对2007年1月至2011年6月间在我院康复病区治疗的108例脑出血患者进行分析，收集每位患者病史，详细记录包括患者性别、年龄、改良Barthel指数（MBI）、Brunnstrom分期等12项临床资料。治疗前、后疗效比较采用配对￡检验，对可能影响脑出血患者功能恢复的相关因素进行单因素分析；对单因素分析具有统计学意义的相关因素再进行多因素逐步线性回归分析。结果出院时脑出血患者MBI评分及Brunnstrom分期（包括上肢、手、下肢）均有明显改善（均P〈0．05）；通过单因素相关分析发现，患者年龄、入院时Brunnstrom分期（包括上肢、手、下肢）、入院时MBI评分与出院时MBI评分具有显著相关性；而康复介入时间、康复疗程、入院时MBI评分与出入院时MBI差值（△MBI）具有相关性；通过多因素分析发现，入院时MBI、入院时上肢Brunnstrom分期、年龄与出院时MBI评分密切相关；康复介入时间、康复疗程与出入院时MBI差值（△MBI）密切相关。结论充分探讨影响脑出血患者出院时MBI及出入院时MBI差值的相关因素有利于临床制订康复方案及评估预后，以促进患者日常生活活动能力尽可能改善。

Objective To explore the factors influencing the recovery of ability in the activities of daily liv- ing （ADL） after intraeerebral hemorrhage. Methods A total of 108 patients with intraeerebral hemorrhage admit- ted for rehabilitation to the rehabilitation medicine department of Huashan Hospital between January 2007 and June 2011 were studied. Twelve items of clinical data were collected with regard to the patients＇ medical history, physical status, modified Barthel index （MBi） score and Brunnstrom stage at admission. Functional status was classified ac- cording to the MBI scores and Brunnstrom stages assessed at admission and before discharge. Linear regression analy- sis was used to relate the variables. Results After rehabilitation, the MBI scores and Brunnstrom stages had im- proved relative to the scores at admission. Factors influencing the MBI improvements included the intervention timing of rehabilitation and the course of therapy employed. Conclusions It is very important to eomprehend the factors influencing the recovery of ADL ability after cerebral hemorrhage in order to design effective rehabilitation strategies, better predict functional outcomes and improve patients＇ ADL ability effectively.