60例缺血性脑卒中患者生活质量调查

目的分析缺血性脑卒中患者的生活质量及影响因素，探讨规范化肢体功能锻炼及健康教育对脑卒中患者生活质量及危险因素改善的意义。方法采用前瞻性研究方法，将60例缺血性脑卒中患者按随机原则分为康复组（30例）及对照组（30例），两组均进行脑卒中二级预防用药及生活方式干预，康复组出院后定期复诊，在指导下坚持进行功能锻炼及健康教育，对照组自行进行肢体功能锻炼。对比治疗6个月前后危险因素（血糖、血脂）的变化，应用SF-36量表对患者出院时、出院后6个月的生活质量进行评定。结果康复组和对照组出院时血糖、血脂比较差异均无统计学意义（均P〉0．05），6个月后两组上述指标均明显改善，且康复组改善程度明显优于对照组[空腹血糖（FPG，mmo]／L）：4．89±0．42比5．21±0．53，总胆固醇（TC，mmol／L）：5．31±1．19比5．54±1．02，甘油三酯（TG，mmol／L）：1．23±0．27比1．62±0．30，高密度脂蛋白胆固醇（HDL-C，mmol／L）：1．59±0．27比1．43±0．51，低密度脂蛋白胆固醇（LDL-C，mmol／L）：3．03±0．95比3．76±0．73，均P〈0．05]；两组经过6个月的康复训练，生理健康和心理健康均得到明显改善，以康复组改善为优[生理机能（PF，分）：70．34±14．77比65．71±17．68，生理职能（RP，分）：70．21±26．12比66．52±32．40，躯体疼痛（BP，分）：79．04±15．22比73．17±16．97，一般健康状况（GH，分）：72．54±16．97比71．27±16．96，精力（vT，分）：66．78±14．20比63．08±15．64，社会功能（sF，分）：79．23±13．50比69．57±18．71，情感职能（RE，分）：79．92±23．21比73．43±31．41，精神健康（MH，分）：75．62±12．37比70．78±13．34，均P〈0．05]。结论重视缺血性脑卒中患者肢体功能锻炼指导及健康教育，能提高患者康复效果及生活质量。

Objective To analyze living quality and risk factors of the patients with ischemic cerebral apoplexy and to approach the significance of standard limb-dirigation and health teaching in improvement of their living quality and risk factors. Methods A prospective study was conducted,in which 60 patients of ischemic cerebral apoplexy were randomly assigned to an observation group and a control group(each,30 cases);both groups were treated with secondary prevention medication and life style interference. After discharge,in the observation group,the patients regularly returned to pay visits and got the guidance to do standard limb-dirigation and health teaching,while in the control group,the patients did limb-dirigation by themselves. The changes of risk factors (blood-sugar,blood-lipid)and of SF-36 scale evaluations of living quality of the patients on the day of discharge and 6 months after discharge were compared. Results The blood-sugar and blood-lipid on the day of discharge indicated no statistical significances between the two groups(all P>0.05);the above indexes of the two groups 6 months after discharge were obviously improved,and the improvement of the observation group was superior to that of the control group〔fasting plasma glucose(FPG,mmol/L):4.89±0.42 vs. 5.21±0.53,total cholesterol (TC,mmol/L):5.31±1.19 vs. 5.54±1.02,triglyceride(TG,mmol/L):1.23±0.27 vs. 1.62±0.30,high-density lipoprotein cholesterol(HDL-C,mmol/L):1.59±0.27 vs. 1.43±0.51,low-density lipoprotein cholesterol(LDL-C, mmol/L):3.03±0.95 vs. 3.76±0.73,all P<0.05〕. The physiological health and mental health of two groups 6 months after discharge were obviously improved and the improvement of the observation group was better than that of the control group〔physiological function(PF,score):70.34±14.77 vs. 65.71±17.68,role of physiology (RP,score):70.21±26.12 vs. 66.52±32.40,body pain(BP,score):79.04±15.22 vs. 73.17±16.97,general health (GH,score):72.54±16.97 vs. 71.27±16.96,vitality(VT,score):66.78±14.20 vs. 63.08±15.64,social function (SF,score):79.23±13.50 vs. 69.57±18.71,emotional role(RE,score):79.92±23.21 vs. 73.43±31.41,mental health(MH,score):75.62±12.37 vs. 70.78±13.34,all P<0.05〕. Conclusion Pay attention to the guidance of standard limb-dirigation and health teaching which are helpful to improve the rehabilitation efficacy and living quality of the patients with ischemic cerebral apoplexy.