北京市社区卫生服务机构缺血性脑卒中残疾情况及其影响因素  

The disability and risk factors after ischemic stroke in Beijing community-based medical centers

作　　者：李慧慧[1] 刘宏军[1] 方向华[1] 穆丽媛 张新卿[1] 

机构地区：[1]首都医科大学宣武医院,北京100053 [2]北京市社区卫生协会,北京100000

出　　处：《中国康复》2015年第2期151-154,共4页Chinese Journal of Rehabilitation

基　　金：北京市科委项目(D121100004912002)

摘　　要：目的:调查在北京市城区基层医疗单位就诊的缺血性脑卒中患者残疾情况及其影响因素。方法:在北京市东城区、宣武区、崇文区、海淀区、石景山区各选一家二级医院,对在这5家医院及其所属的社区卫生服务中心/站就诊的首次或二次缺血性脑卒中急性起病后3个月以上的患者进行横断面调查,采用Barthel指数(BI)量表进行残疾评估,定义BI<95为残疾。结果:入选并完成BI评估的缺血性脑卒中患者1071例,总残疾率为21.76%(233/1071),轻度和重度残疾分别占78.11%(182/233)和21.89%(51/233)。脑卒中残疾率随年龄增加、文化程度降低而上升(P<0.01),男性患者、脑卒中复发、伴有糖尿病、认知功能障碍、抑郁患者的残疾率明显增加(P<0.05),脑血栓形成患者的残疾率明显高于腔隙性脑梗死患者(P<0.05)。结论:残疾为脑卒中后常见并发症之一,在社区病情稳定的恢复期缺血性脑卒中患者中有20%患有残疾,年龄增加、脑卒中复发、合并糖尿病、认知功能障碍是脑卒中后残疾的独立危险因素。Objective：To investigate the disability and risk factors among ischemic stroke survivors in community medical centers of urban Beijing.Methods：A cross-sectional study was conducted in 5community-based medical centres afflilated to grade 2hospital located in Dongcheng district,Xuanwu district,Chongwen district,Haidian district and Shijingshan district of urban areas of Beijing.Patients with the history of first or second ischemic stroke more than 3months after the onset were evaluated from Jan.2003 to Dec.2006.Barthel Index（BI）was used to assess disability.The disability was defined as BI 95.Results：There were 1071 patients who had joined and completed BI assessment.Total disability rate was 21.76%（233/1071）,and the proportion of mild and severe disability was 78.11%（182/233）and 21.89%（51/233）respectively.The rate of disability increased with age,also increased with education level reduction（χ2 trend test：P0.0001）.The disability rate significantly increased in males,recurrent stroke and combination with diabetes,cognitive impairment and depression（P〈0.05）.The patients with cerebral thrombosis showed higher rate of disability than in those with lacunar infarction（P〈0.05）.Conclusions：Disability is one of common complications after stroke.One fifth parients were suffered with disability at stable recovery period in Beijing community.Aging,male,recurrent stroke and combination with diabetes,cognitive impairment are the independent risk factors for disability after stroke.

关 键 词：缺血性脑卒中 残疾 危险因素 

分 类 号：R49[医药卫生—康复医学] R743.3[医药卫生—临床医学]