中期照护对亚急性期脑卒中患者出院后日常生活能力的影响

Effect of intermediate care on daily life ability of subacute stroke patients after discharge

目的：观察中期照护对亚急性期脑卒中患者出院后日常生活能力的影响，探讨提高亚急性期脑卒中患者出院后日常生活自理能力的方法。方法2014年6月—2015年6月，选取南京医科大学附属淮安第一医院神经内科病房收治的64例脑卒中患者，其中脑出血20例，脑梗死22例，蛛网膜下腔出血22例；按照信封法随机将患者分成研究组32例和对照组32例；研究组采用中期照护的方法，由照护团队按照计划对患者实施照护，对照组采用传统的照护方法，比较两组患者出院后日常生活自理能力、并发症及再住院情况。结果两组患者出院时Barther评分差异无统计学意义（ P〉0.05）；出院2，4，6周后，研究组患者的Barther评分明显高于对照组，差异有统计学意义（ P〈0.05）；出院6周后两组患者并发症比较：研究组患者出现并发症2例，其中胃管滑脱1例、胃内容物误吸1例，对照组患者出现并发症10例，其中压疮4例、胃管堵塞或滑脱3例、胃内容物误吸1例、泌尿系统感染2例，两组比较差异有统计学意义（χ2＝6.564，P〈0.05）；研究组的再住院率低于对照组，差异有统计学意义（P〈0.05）。结论中期照护可以明显提高亚急性期脑卒中患者出院后日常生活能力，减少并发症，降低再住院率。

Objective To explore the effect of intermediate care on daily life ability of subacute stroke patients after discharge.Methods A total of 64 subacute stroke patients between June 2015 and June 2016 in our hospital were selected, including 20 cases of cerebral hemorrhage, 22 cases of cerebral infarction, and 22 cases of subarachnoid hemorrhage. They were randomly divided into observation group （ n=32） and control group （ n=32） . The intermediate care was performed by the care team according to the plan in observation group and the traditional care was provided in control group. The daily life ability, complications and rehospitalization rate were compared between two groups after discharge.Results There was no significant difference in the score of Barther between two groups at discharge （P〉0.05）. The scores of Barther in observation group were higher than those in control group at 2 w, 4 w, and 6 w after discharge, and the differences were statistically significant （ P〈0.01） . After 6w after discharge, there were 2 cases of complications in observation group, including 1 case of gastric tube detachment and 1 case of aspiration of gastric contents. There were 10 cases of complications in control group, including 4 cases of pressure ulcer, 3 cases of gastric tube blockage or detachment, 1 case of aspiration of gastric contents, and 2 cases of urinary tract infection. The difference between two groups was statistically significant （χ2=6.564,P〈0.05） . The rehospitalization rate in observation group was lower than that in control group, and the difference was statistically significant （P〈0.05）.Conclusions The intermediate care can improve the daily life ability, decrease the complications and rehospitalization rate of subacute stroke patients after discharge.