脑卒中后患者残疾危险因素及接受度分析

Analysis on risk factors of after-stroke disability and patients＆#39; acceptance

目的 探讨脑卒中后残疾的危险因素,并对患者的残疾接受度及其影响因素进行分析.方法 采用随机抽样的方法选取大庆市油田总医院2014年2月—2016年8月收治的650例脑卒中患者为研究对象,采用自制量表收集患者的一般资料及伤残程度评分,采用伤残接受度量表（AODS）对残疾患者的残疾接受度进行评定,用单因素分析、多元逐步回归分析患者脑卒中后残疾的危险因素及患者残疾接受度的影响因素.结果 不同性别、有无脑卒中家族史、有无高血脂患者的残疾发病率差异无统计学意义（χ2值分别为0.729、1.900、0.007;P〉0.05）;不同年龄段、不同文化程度、有无糖尿病及有无高血压患者的残疾发病率均差异有统计学意义（χ2值分别为7.350、10.321、8.365、7.694;P〈0.01）.年龄、有糖尿病、文化程度是脑卒中后残疾的独立危险因素.本研究中104例残疾患者的AODS总分为（76.65±14.32）分,中度接受百分比为85.6%.不同年龄、不同文化程度、有无糖尿病及有无高血压患者的AODS评分不同,差异有统计学意义（t/F值分别为4.153、4.478、7.893、8.015;P〈0.05）,年龄、文化程度、有高血压、有糖尿病为脑卒中后残疾患者AODS的影响因素.结论 年龄、有糖尿病、文化程度是脑卒中后残疾的独立危险因素,应针对危险因素进行积极预防;针对不同情况患者的AODS评分对患者进行积极的心理干预,提高患者对脑卒中后残疾的接受度.

Objective To discuss risk factors of after-stroke disability, and to analyze the patients＆#39; acceptance of this disability and influencing factors.Methods By random sampling, 650 cases of cerebral apoplexy patients, treated in Daqing Oilfield General Hospital from February 2014 to August 2016, were selected, with their general data and scores of disability degree collected by a self-designed questionnaire. The acceptance of disability scale （AODS） was used for scaling the patients＆#39; acceptance of this disease. Risk factors for after-stroke disability and influencing factors of the patients＆#39; acceptance of the disability were analyzed by single factor analysis and multiple stepwise regression analysis.Results There was no statistical difference of incidence of disability among patients with different gender, family history, or whether with hyperlipidemia （χ2=0.729, 1.900, 0.007;P〉0.05）; there were statistical difference of incidence of disability among patients with different ages, educational degree, whether with diabetes, or whether with high blood pressure （χ2=7.350, 10.321, 8.365, 7.694;P〈0.01）. Age, diabetes and educational degree were independent risk factors of after-stroke disability. In this study, total AODS scores of the 104 patients with disability were （76.65±14.32） points, with a moderate accept percentage 85.6%. There was statistical difference of AODS scores of patients with different ages, educational degree, whether with diabetes or whether with high blood pressure （t/F=4.153, 4.478, 7.893, 8.015;P〈0.05）. Age, educational degree, whether with high blood pressure or whether with diabetes were factors influencing AODS of disabled patients after stroke.Conclusions Age, diabetes, educational degree are independent risk factors of disability after stroke, according to which, targeted positive prevention should be taken. Patients with different circumstances should be intervened psychologically according to their AODS scores, which helps to improve their acceptance of disability after stroke.