康复结对指导模式对脑卒中患者患肢功能及日常生活活动能力的疗效

Effect of Rehabilitation Cooperation Network on Motor Function and Activities of Daily Living in Stroke Patients

目的探讨社区康复结对指导模式对脑卒中患者功能障碍及日常生活活动能力的影响。方法 2016年1月至2018年3月,在10家社区卫生服务中心住院治疗的脑卒中患者200例随机分为对照组和治疗组,各100例。治疗组由康复科康复医师、技师、护师与社区相关人员结对,每周1次到结对社区指导康复治疗和康复护理,为患者制定康复计划;通过微信群进行远程康复和护理指导。对照组由社区自行拟定治疗方案。治疗前、治疗3周后、治疗后2个月随访时,采用Fugl-Meyer评定量表(FMA)、改良Barthel指数(MBI)对患者进行评定。结果治疗后和随访期,治疗组上下肢FMA评分和MBI评分均较治疗前明显提高(t>2.710, P<0.01);对照组上肢FMA评分在治疗后提高(t=-2.195, P<0.05),随访时与治疗前无显著性差异(t=-1.394, P>0.05),下肢FMA评分治疗后和随访期均显著提高(t>3.828, P<0.001),MBI评分治疗后和随访期均无明显改变(t<1.774, P>0.05)。治疗组各时间点上下肢FMA评分和MBI评分均明显优于对照组(t>3.155, P<0.01)。结论脑卒中社区康复协作的结对指导服务模式能够较好提高患者日常生活活动能力,改善患肢功能障碍。

Objective To explore the effect of community rehabilitation collaborative service on stroke patients.Methods From January,2016 to March,2018,200 stroke inpatients from ten community health service centers(CHSC)were divided into control group(n=100)and treatment group(n=100).The physicians,therapist and nurses of rehabilitation department were paired with CHSC personnels,to guide rehabilitation treatment and nursing,fieldly and through WeChat group.They were evaluated with Fugl-Meyer Assessment(FMA)and modified Barthel Index(MBI)before treatment,three weeks after treatment,and two months afterwards.Results The FMA scores of upper and lower extremities and MBI scores improved after treatment and follow-up in the treatment group(t>2.710,P<0.01).For the control group,the FMA score of upper extremities improved after treatment(t=-2.195,P<0.05),but it was not significantly different from pre-treatment as follow-up(t=-1.394,P>0.05);the FMA score of lower extremities improved both post-treatment and follow-up(t>3.828,P<0.001);the MBI score did not improve after treatment and follow-up(t<1.774,P>0.05).The FMA score of upper and lower extremities and MBI score improved more in the treatment group than in the control group after treatment and follow-up(t>3.155,P<0.01).Conclusion The community rehabilitation collaborative service can improve the motor function and activity of daily living in stroke patients.