脑卒中医院-社区-家庭三级连续康复治疗的效果评价

Effect Evaluation of Hospital-community-family Tertiary Rehabilitation in Stroke

目的:观察脑卒中急性期后在"医院-社区-家庭三级康复治疗"、持续在大医院康复治疗和家庭康复三种方案的治疗效果及医疗费用的差异。方法:随机选取101例脑卒中患者分为三组,A组:30例,医院-社区-家庭三级康复治疗;B组:30例,持续在大医院康复治疗者。C组:41例,从综合医院内科直接进入家庭康复治疗者;三组分别在康复治疗前与治疗后3个月、6个月采用Barthel指数、简化的Fugl-Meyer评定量表、社区康复肢体残疾功能评定表(CEDA)进行评估,比较三组同期之间ADL、运动功能改善以及回归社会情况的差异和治疗费用差异。结果:三组患者康复治疗前ADL评分、简化的Fugl-Meyer评分、CEDA评分无显著差异(P>0.05);康复治疗后3个月、6个月评估,A与B组比较无显著差异(P>0.05)。A与C比较差异具有统计学意义(P<0.05);A与B组治疗费比较,A组明显少于B组。结论:"医院-社区-家庭三级康复治疗"与大医院康复治疗同样可以提升脑卒中患者的ADL、运动功能,减轻肢体残疾情况,治疗费用方面前者具有价廉优势。

Objective： To observe the differences of ~eatment and medlical costs between ＂hospital-communi- ty-family＂ tertiary rehabilitation and hospitals continued treatment and rehabilitation at home in the acute phase of stroke. Methods： Randomly selected 101 cases of stroke patients were divided into three groups. Group A： 30 patients treated in ＂hospital- community-family＂ tertiary rehabilitation agencies; Group B： 30 patients continuously treated in large hospitals, Group C： 41 patients from General Hospital internal medicine directly into family therapy. Three groups assessed with the Barthel index, simplified Fugl-Meyer scale, Community Extremity Disabihty Assessment Schedule （CEDA） before and 3 months, 6 months after treatment respectively, compared differences of the three groups of ADL, motor function, and returning to society. At the same time, the costs were investigated as well. Results： Three groups of patients＇ ADL score and simplified Fugl-Meyer score and CEDA score was no significant difference （P〉 0.05） before treatment. Differences between group A and group B above indicators were no significant difference （P〉0.05） in 3 months and 6 months after treatment. Differences between group A and group C above indicators was statistically significant （p〈0.05）. Group A in treatment cost less than group B. Conclusion： ＂Hospital-community- family＂ tertiary rehabilitation and hospitals continued treatment can improve the ADL and motor function in stroke patients, reducing their physical disability. Tertiary rehabilitation enjoys the price advantage as to the costs of treatment.