出院干预计划对脑卒中患者预后的影响

Effect of discharge intervention plan on the prognosis of stroke patients

目的探讨出院干预计划对脑卒中后患者预后的影响。方法将120例脑卒中患者采用随机数字表法分为对照组（60例）和观察组（60例），两组住院期间均接受神经内科常规护理外，观察组在此基础上给予出院干预，成立干预队伍，制定出院计划，培训患者和照顾者相关知识，制定康复训练流程，联系社区医护人员，介绍社区资源，上门随访和电话随访。两组患者出院后随访6个月，采用Barthel指数（BI）评价患者日常生活活动能力，比较两组患者遵医行为和二次卒中率。结果出院后6个月，观察组BI评分为（91．40±5．33）分，对照组为（81．57±9．58）分，组间比较差异有统计学意义（t=6．696，P〈0．01）。观察组患者遵医行为依从性高于对照组（x2值分别为20．809，25．724，40．377，28．831，36．77；P〈0．05）。观察组患者随访期间二次卒中率为5．5％，对照组为17．9％，两组比较差异有统计学意义（x2：4．128，P〈0．05）。结论脑卒中患者出院计划护理方案，能够降低脑卒中患者二次卒中率，提高患者出院后日常生活能力，对患者远期预后有一定的影响。

Objective To discuss the effect of discharge intervention plan on the prognosis of stroke patients. Methods A total of 120 stroke patients were randomly divided into the control group and the observation group, each with 60 cases. Both groups received regular neurological nursing, and the observation group was given discharge intervention in addition, in which intervention troop was established, discharge plan was made, both patients and caregivers were trained, rehabilitation training procedure was formulated, community medical staff was communicated, community resource was introduced, door-to-door follow up and telephone follow up were taken. Both two groups were followed up for 6 months after discharge, BI was used to evaluate patients＇ activities of daily living ability, and their compliance and rate of second stroke were compared. Results Six months after discharge, BI score was （91.40 ± 5.33 ） in the observation group and （81.57± 9.58） in the control group, and the difference was statistically significant （t = 6. 696,P 〈 0. 01）. The compliance was better in the observation group than that in the control group （ X2 = 20. 809,25. 724,40. 377, 28. 831,36.77; P 〈0. 05）. The rate of second stroke was 5.5% （3/55） in the observation group and 17% （10/56） in the control group, and the difference was statistically significant （X2= 4. 128, P 〈 0. 05）. Conclusions Discharge intervention plan for stroke patients can reduce their rate of second stroke, improve their daily living ability, and has a oositive effect on the long-term prognosis in stroke patients.