脑卒中患者社区站点家庭一体化康复疗效的分析

Analysis of the effect of the integrated rehabilitation of community health service stations with families on stroke patients

目的:评估社区站点家庭一体化康复对脑卒中的疗效。方法:抽取社区90例脑卒中患者,随机分为康复组(45例)和对照组(45例)。康复组的平均年龄(72.9±9.9)岁,对照组的平均年龄(73.0±7.8)岁。康复组的患者在经过康复评估后,接受站点家庭一体化康复治疗干预,由治疗师和中医师在站点进行指导和治疗,家属在家协助治疗,包括手法治疗、作业治疗、物理治疗、中医传统康复治疗和日常生活能力训练,并对家属进行培训和让家属协同训练。对对照组患者不采取康复治疗,在整个研究过程中两组药物治疗方案维持不变。3个月后采用简明精神状态量表(MMSE)、简易Fugl-Meyer运动量表、改良Barthel指数评定量表对两组患者认知功能、运动功能、日常生活活动能力进行评价。结果:干预后,康复组患者的认知功能、运动功能、日常生活能力均有明显提高(P<0.001);对照组患者的认知功能、日常生活活动能力也有明显提高(P<0.005),运动功能没有明显改善(P>0.05)。但康复组的认知功能、日常生活活动能力得分均明显高于对照组(P<0.005)。结论 :脑卒中社区站点家庭一体化康复治疗能够有效地改善脑卒中患者认知功能、运动功能和日常生活活动能力,是适合社区的康复模式,可进一步在社区探索和推广。

Objective： To evaluate the efect of the integrated rehabilitation of community health service stations with families on stroke patients. Methods： Ninety patients were enrolled in the community and randomly divided into a rehabilitation group（45 cases） and a control group（45 cases）. The average age of the rehabilitation group was （72.9±9.9） years, and the average age of the control group was （73±7.8） years. After rehabilitation assessment, the patients in the rehabilitation group received the treatment intervention by integrated rehabilitation of community health service stations with families, and the therapists and the herbalists of the community health stations provided guidance and treatment and the family members helped with the treatment at home, including manual therapy, occupational therapy, physical therapy, traditional Chinese medicine rehabilitation treatment and daily living ability training. The family members were trained and let them cooperate the training. The patients in the control group did not take rehabilitation treatment. Both groups maintained drug regimens unchanged throughout the course of the study. Three months later, a Mini-mental state examination scale （MMSE）, a simple Fugl-Meyer motor function scale and a modified Barthel index scale were used to evaluate the cognitive function, motor function and activity ability of daily living of the patients in the two groups. Results： After the intervention, the cognitive function, motor function and activity ability of daily living of the rehabilitation group were significantly improved（P〈0.001）. The cognitive function and activity ability of daily living of the patients in the control group were also signi？cantly improved too（P〈0.005）, and motor function was not improved signi？cantly（P〉0.05）. But the scores of cognitive function and activity ability of daily living in the rehabilitation group were signi？cantly higher than those in the control group（P〈0.005）. Conclusion： The integrated rehabilitation of community health service stations with families can efectively improve the cognitive function, motor function and activity ability of daily living of the stroke patients, is a rehabilitation mode suitable for the community, and can be further explored and promoted in the community.