缺血性脑卒中社区康复临床路径的疗效研究:多中心、单盲、随机对照前瞻性研究  

The effect of community rehabilitation clinical pathway on functional recovery in patients with ischemic stroke

作　　者：邹颖[1] 王红星[1] 付娟娟[1] 任彩丽 刘守国[1] 伊文超[1] 夏楠[1] 蔡德亮 陈伟[3] 万春晓 沈光宇[5] 潘化平 冯玲[7] 项洁 苏敏[9] 王德强[10] 励建安[1] 

机构地区：[1]南京医科大学第一附属医院,南京210029 [2]无锡市同仁(国际)康复医院 [3]徐州市中心医院 [4]天津医科大学总医院 [5]南通大学医学院附属医院 [6]南京医科大学附属江宁医院 [7]绍兴市人民医院 [8]徐州医科大学附属医院 [9]苏州大学第一附属医院 [10]滨州医学院附属医院

出　　处：《中国康复医学杂志》2017年第9期1035-1039,共5页Chinese Journal of Rehabilitation Medicine

基　　金：江苏省临床医学科技专项项目(BL2012029)

摘　　要：目的:从临床功能角度评估缺血性脑卒中社区康复临床路径康复方案的效果,为脑卒中社区康复临床路径的优化和推广提供数据支持。方法:采用随机、单盲、平行对照、多中心的前瞻性研究,符合纳入标准的缺血性脑卒中患者247例,随机分为临床路径组(129例)和常规康复组(118例)。临床路径组进入社区康复临床路径并执行相应康复治疗方案,常规康复组采取常规康复治疗,不进入临床路径,对康复治疗内容及时间不做要求。主要结局指标采用改良Barthel指数(MBI)及次要结局指标Fugl-Meyer运动功能评分量表(FMA)对两组患者ADL能力、综合功能水平、运动功能进行评定和分析。结果:临床路径组康复治疗前后的MBI差值、MBI改善程度均显著高于常规康复组,差异有显著性意义(P<0.05)。两组患者康复治疗前后FMA差值及FMA改善程度比较,差异有显著性意义(P<0.05)。结论:社区康复临床路径结合规范化的康复方案能提高缺血性脑卒中患者的ADL能力,改善患者的功能。Objective： To investigate the effect of clinical pathway in community on functional recovery for patients with ischemic stroke.Method： A total of 247 patients with ischemic stroke were randomized into clinical pathway group and conventional rehabilitation group. Patients in the clinical pathway group were treated according to specific rehabilitation program, while the conventional rehabilitation group received routine rehabilitation program. Modified Barthel index（MBI） and the Fugl-Meyer motor assessment scale（FMA） were performed separately before and after clinical pathway intervention.Result： The difference of MBI between pre-treatment and post-treatment and percent of MBI improvement in the clinical pathway group were significantly higher than those in the conventional group（P0.05）. The FMA＇s difference and FMA improvement after treatment between the clinical pathway and the conventional group alsoelevated obviously than the conventional group（P0.05）.Conclusion： Community rehabilitation clinical pathway combined with standard rehabilitation program can effectively improve the ability of daily living and motor function of ischemic patients.

关 键 词：临床路径 脑卒中 社区康复 日常生活活动能力 改良BARTHEL指数 Fugl-Meyer运动功能评分量表 

分 类 号：R493[医药卫生—康复医学] R743.3[医药卫生—临床医学]