中风多专业一体化管理模式对脑梗死患者生活质量及疗效研究

The Study on the quality of life and effect of multi-disciplinary integrated management model in patients with cerebral infarction

目的:中风病具有发病急重、进展迅速、致死及致残率高等特点。本研究基于科室多专业一体化平台模式,分析中风多专业一体化管理模式对脑梗死患者生活质量及疗效,以期进一步推广应用。方法:临床选择南京市中医院住院的脑梗死急性期患者100例,根据随机数字表分为观察组50例和对照组50例。对照组采用普通康复治疗,观察组在常规康复训练的基础上按多专业一体化模式进行干预。两组均连续治疗2周,然后进行1、3、6个月随访。评估脑梗死患者的神经功能(National Institutes of Health Stroke Scale,NIHSS)、日常生活活动能力(Acticities of Daily Living,ADL)、脑卒中专用生活质量量表(Stroke Special Quality of Life,SS-QOL)及脑卒中影响量表(Stroke Impact Scale,SIS)。根据随访结果评定不同时间段患者的疗效。结果:观察组NIHSS评分以及ADL评分得到显著提高,与对照组比较有统计学意义(P<0.05)。观察组患者的SS-QOL量表生活质量的改善优于对照组(P<0.05)。干预1个月观察组的移动及手功能得分有差异,与对照组比较差异有统计学意义(P<0.05);干预3个月、6个月后,力量维度、ADL、移动维度、手功能维度、参与维度两组比较差异有统计学意义(P<0.05);情绪、交流均有一定程度改善,前后比较差异有统计学意义(P<0.05),但组间比较差异无统计学意义(P>0.05);两组的认知功能前后比较差异无统计学意义(P>0.05)。结论:中风多专业一体化诊疗模式有助于脑梗死急性期患者的神经功能康复,观察组患者参与度提高,能够进一步改善患者的生活质量及生活能力,值得临床推广应用。

Objective:Stroke is characterized by severe onset,rapid progression,and high mortality and disability rates.Based on the multi-disciplinary integration platform mode of department,this study analyzes the quality of life and efficacy of the multi-disciplinary integration management mode of stroke on patients with cerebral infarction,with a view to further promote its application.Methods:One hundred cases of acute cerebral infarction hospitalized in Nanjing Hospital of Traditional Chinese Medicine were divided into a multi-disciplinary integration treatment group of 50 cases and a control group of 50 cases according to a random number table.The conventional rehabilitation group received ordinary rehabilitation treatment,and the multi-disciplinary integration group received a multi-disciplinary integration mode on the basis of conventional rehabilitation training.Both groups were treated continuously for 2 weeks,and then followed up for 1,3,and 6 months.The neurological function(NIHSS),Activities of daily living(ADL)and the Stroke Special Quality of Life Scale(SS-QOL)and Stroke Impact Scale(SIS)in patients with cerebral infarction were assessed.Results:NIHSS and ADL of the multi-disciplinary integration group were significantly improved,which showed a statistically significant difference compared with the conventional treatment group(P<0.05).The improvement of the SS-QOL scale of the multi-disciplinary integration group was better than the control group(P<0.05).After 1 month of intervention,the scores of movement and hand function of the multi-disciplinary integration group were different compared with those of the control group(P<0.05),after 3 and 6 months of intervention,the strength dimensionality,ADL,and movement dimensions,hand function dimensions,and participation dimensions were of statistically significant differences between the two groups(P<0.05);emotions and communication were improved,and the difference after treatment was statistically significant(P<0.05).There was no significant difference in the cognitive function between the two groups before and after treatment(P>0.05).Conclusion:The multi-disciplinary integration diagnosis and treatment model for stroke is helpful to the neurological rehabilitation of patients with acute cerebral infarction,the multi-disciplinary integration group can further improve the patient's quality of life and living ability,which is worthy of clinical application.