卒中中心超早期康复治疗对急性脑出血并发症及康复效果的影响

Influence of Ultra-early Rehabilitation Treatment in Stroke Center on Complications and Rehabilitation Effect of Acute Cerebral Hemorrhage

目的:探究卒中中心超早期康复治疗对急性脑出血并发症患者及康复效果的影响。方法:选取涟水县人民医院康复医学科2018年1月—2019年12月收治的40例急性脑出血患者,按照随机数表法分为卒中中心病房组(卒中中心超早期康复治疗方法)和普通病房组(常规时期康复治疗方法),每组各20例,观察入院及结束治疗时神经功能缺损(NIHSS)评分和日常生活能力(ADL)、Barthel指数评分、住院期间感染情况及死亡情况、治疗有效率、并发症发生情况及住院时间。结果:卒中中心病房组治疗有效率为90.0%,普通病房组治疗有效率为70.0%,卒中中心病房组并发症发生率10.0%,普通病房组并发症发生率为30.0%,差异有统计学意义(χ^(2)=4.329、4.800,P<0.05)。两组患者康复治疗前NIHSS评分和ADL Barthel指数评分差异无统计学意义(P>0.05),康复治疗后卒中中心病房NIHSS评分低于普通病房组,卒中中心病房ADL Barthel指数评分高于普通病房组,差异有统计学意义(t=2.877、2.074,P<0.05)。卒中中心病房组泌尿道感染、肺部感染例数低于普通病房组,差异有统计学意义(χ^(2)=4.800、4.329,P<0.05),两组患者脑部直接原因死亡例数相同,卒中中心病房组非脑部直接原因死亡例数低于普通病房组,差异有统计学意义(χ^(2)=0.000、4.444,P<0.05)。卒中中心病房组患者平均住院时间短于普通病房组,差异有统计学意义(P<0.05)。结论:卒中中心模式下超早期康复训练患者康复效果好,并发症少,有利于急性脑出血患者的恢复。

Objective: To explore the impact of ultra-early rehabilitation treatment in stroke centers on the complications and rehabilitation effects of acute cerebral hemorrhage. Methods: Forty patients with acute cerebral hemorrhage admitted to the hospital from January 2018 to December 2019 were selected and divided into stroke unit ward group(ultra-early rehabilitation therapy for stroke unit) and general ward group(routine rehabilitation treatment methods) according to the random number table method,with 20 cases in each group. The neurological impairment(NIHSS) score, the ability of daily living(ADL) score, Barthel index score at admission and at the end of treatment, infection and death during hospitalization, treatment efficiency and complications were observed. Results: The effective rate of treatment in the stroke unit ward group was 90.0%, the effective rate in the general ward group was 70.0%, the complication rate in the stroke unit ward group was 10.0%, and the complication rate in the general ward group was 30.0%. The differences were statistically significant(χ;=4.329, 4.800, P<0.05). There was no statistically significant difference in NIHSS score and ADL Barthel index score between the two groups before rehabilitation(P>0.05). After rehabilitation, the NIHSS score in the stroke unit ward was lower than that in the general ward group, and the ADL Barthel index score in the stroke unit ward was higher in the general ward group, the difference was statistically significant(t=2.877, 2.074, P<0.05).The number of urinary tract infections and lung infections in the stroke unit ward group was lower than that in the general ward group, and the difference was statistically significant(χ;=4.800, 4.329, P<0.05). The number of deaths from direct causes was the same, and the number of deaths from non-brain direct causes in the stroke unit ward group was lower than that in the general ward group, the difference was statistically significant(χ;=0.000, 4.444, P<0.05). The average length of stay in the stroke unit ward group was shorter than that in the general ward group, and the difference was statistically significant(P<0.05). Conclusion:Ultra-early rehabilitation training patients under the stroke center model has good rehabilitation effects and fewer complications,which is beneficial to the recovery of patients with acute cerebral hemorrhage.