老年脑卒中住院患者12OO例治疗模式分析  

Analysis of treatment model for stroke in 1200 elderly inpatients

作　　者：张国平[1] 屈晓霞[1] 薛萍[1] 冯欢霞[1] 

机构地区：[1]北京世纪坛医院神经内科,100038

出　　处：《中华老年医学杂志》2010年第9期721-724,共4页Chinese Journal of Geriatrics

摘　　要：目的 比较老年脑卒中住院患者普通模式和卒中单元模式治疗结果的差异,探讨脑卒中治疗的规范化管理模式,提高疗效,减轻病残程度,降低病死率.方法 2002年4月至2007年4月入住我院的急性脑血管病患者1200例,按单双数入住卒中单元和普通病房.观察指标包括病死率、住院时间、生活能力评价（BI）、神经功能评价（NIHSS）、社会功能评价（OHS）,出院时患者或家属满意度评分,分析卒中单元的效果.结果 卒中单元组并发症和病死率明显低于普通病房组,病死率分别为5.0%和13.5%（χ2=26.66,P〈0.01） 出院时BI、NIHSS、OHS、满意度评分比较,卒中单元组明显优于普通病房组（P〈0.05） 卒中单元组住院时间短于普通病房组,分别为（24.1±9.1）d和（25.3±10.5）d（t=2.12,P〈0.05）,但两组住院费用差异无统计学意义（P〉0.05）.结论 卒中单元模式有利于脑卒中患者治疗和康复,可改善患者肢体活动能力,提高生活质量,降低病死率 与传统疗法相比,不会增加患者费用.Objective To compare the differences in curative effect between general treatment model and stroke unit model in the treatment of stroke in the elderly inpatients, to explore the standardized management model, for improving efficacy and reducing the degree of invalidity and mortality. Methods A total of 1200 cases with acute cerebrovascular disease were admitted into our department from April 2002 to April 2007. All patients were randomly assigned either into stroke unit or general ward to receive treatment, and the data of two groups were compared. The key indexes included mortality, hospitalization time, Barthel Index （BI）, National Institutes of Health Stroke Scale （NIHSS） and Oxford Handicap Scale （OHS）. All the patients or their family members were asked to have the Visual Analogue Scales （VAS）. The data of cost and effect were analyzed with SPSS software. Results The complication rate and mortality rate were significantly lower in stroke unit group than in general ward group （P〈 0.01）. The scales of BI, NIHSS, OHS and VAS were significantly better in stroke unit group than in general ward group when discharged （P〈0.05）. The hospitalization time was shorter in stroke unit group than in general ward group （P〈0.05）. There was no significant difference in the costs of hospitalized patients between the two groups （P〉0.05）.Conclusions Stroke unit model can improve the physical activity and life quality of patients and reduce disease mortality without increasing the cost of patients.

关 键 词：脑血管意外 康复 医师诊疗模式 

分 类 号：R743.3[医药卫生—神经病学与精神病学]