不同年龄脑卒中患者出院后六个月康复状况的调查研究

Investigation on the rehabilitation status of patients with cerebral apoplexy at different ages six months after discharge from hospital

目的探讨不同年龄脑卒中患者出院后6个月的康复状况。方法采用Barthel指数评定量表、改良Rivermead移动指数量表、Zung抑郁自评量表和自行设计的自我康复锻炼情况调查表,对2017年4月-2019年7月经四川大学华西医院康复科治疗出院后6个月的207例脑卒中患者进行日常生活能力、移动能力、抑郁及自我康复锻炼情况的横断面调查,并对中青年(≥20且<60岁)和老年(≥60岁)脑卒中患者的康复状况进行对比分析。结果207例患者中,老年组91例,中青年组116例。出院后6个月,老年组患者的日常生活能力功能障碍发生率(97.8%vs.90.5%;χ^(2)=4.598,P=0.032)和抑郁发生率(51.2%vs.36.2%;χ^(2)=4.043,P=0.044)高于中青年组患者,而移动能力总分[(26.38±9.77)vs.(29.47±10.60)分;t=2.154,P=0.032]和自我康复锻炼者比例(93.4%vs.100.0%;χ^(2)=5.708,P=0.017)低于中青年患者。结论在延续康复护理的过程中,应根据不同年龄实施不同的康复护理措施,重点关注老年脑卒中患者,加强对老年患者的日常生活能力和移动能力的康复训练、心理护理及自我康复锻炼依从性的监督和促进。

Objective To investigate the rehabilitation status of patients with cerebral apoplexy at different ages six months after discharge from hospital.Methods Using the Barthel Index,the Modified Rivermead Mobility Index,the Zung Self-rating Depression Scale,and a self-designed rehabilitation exercise questionnaire,we conducted a crosssectional investigation on the daily living ability,mobility,depression,and self-rehabilitation exercise of 207 stroke patients six months after discharge,who were discharged from the Rehabilitation Department of West China Hospital of Sichuan University between April 2017 and July 2019.The rehabilitation status of young and middle-aged(≥20 and<60 years old)stroke patients and elderly(≥60 years old)stroke patients were compared.Results There were 91 elderly patients and 116 young and middle-aged patients.Six months after discharge,the incidences of dysfunction in daily living ability(97.8%vs.90.5%;χ^(2)=4.598,P=0.032)and depression(51.2%vs.36.2%;χ^(2)=4.043,P=0.044)were higher in the elderly patients than those in the young and middle-aged patients,and the mobility score(26.38±9.77 vs.29.47±10.60;t=2.154,P=0.032)and the proportion of patients taking self-rehabilitation exercise(93.4%vs.100.0%;χ^(2)=5.708,P=0.017)were lower in the elderly patients than those in the young and middle-aged patients.Conclusions In the process of continued rehabilitation nursing,different rehabilitation nursing measures should be implemented according to different ages,focusing on elderly stroke patients,and strengthening the supervision and promotion of rehabilitation training of daily living ability and mobility,psychological nursing and self-rehabilitation exercise compliance of elderly patients.