家庭康复指导对脑卒中患者肢体功能和生存质量的影响  

Influence of family rehabilitation on limb function and quality of life in patients after stroke

作　　者：张明[1,2] 李书钢 朱茜[1,3] 胡杰 吴琼[3] 刘康 Zhang Ming;Li Shugang;Zhu Qian;Hu Jie;Wu Qiong;Liu Kang(Department of Rehabilitation Medicine,Xuzhou Central Hospital/Xuzhou Medical University School of Rehabilitation Medicine,Xuzhou 221009,China;Department of Rehabilitation Medicine,Xuzhou Rehabilitation Hospital,Xuzhou 221006,China;Department of Rehabilitation Medicine,Taishan Community Health Service Center of Quanshan District,Xuzhou 221006,China)

机构地区：[1]徐州市中心医院康复医学科/徐州医科大学康复医学院,221009 [2]徐州市康复医院康复科,221006 [3]徐州市泉山区泰山社区卫生服务中心康复治疗部,221006

出　　处：《中华临床医师杂志（电子版）》2017年第19期2253-2258,共6页Chinese Journal of Clinicians(Electronic Edition)

基　　金：江苏省青年医学人才基金(QNRC2016376);徐州市医学青年后备人才工程资助(2016015)

摘　　要：目的探讨家庭康复治疗指导对脑卒中偏瘫患者肢体功能恢复和生存质量的影响,并比较其与住院康复治疗和门诊随访指导之间的区别。方法选取2012年12月至2015年6月在徐州市中心医院和徐州市康复医院住院康复治疗的符合入组标准的脑卒中患者45例,采用随机数字表法其分为家庭康复组、住院康复组及门诊随访组,每组15例。3组患者均曾在我院进行过常规综合康复治疗,住院康复组继续以上治疗,出院后家庭康复组进行入户家庭康复训练指导,门诊随访组进行每月1次的门诊随访。于入组时即常规康复治疗后以及治疗3个月和6个月后对3组患者Fugl-Meyer运动功能评测(FMA)、改良Barthel指数(MBI)以及生存质量健康调查简表(SF-36)进行评估对比,同时比较3组患者治疗前后月平均医疗费用支出情况。结果入组时3组患者在FMA评分、MBI评分以及SF-36评分方面相比较均无明显差异,家庭康复组治疗3个月后FMA评分、MBI评分以及SF-36评分分别为(60.26±10.46)、(66.36±9.25)、(62.55±12.95)分,6个月后分别为(74.58±11.58)、(77.12±12.78)、(79.52±11.32)分,住院康复组治疗3个月后评分分别为(63.28±12.59)、(68.21±11.35)、(79.52±11.32)分,6个月后分别为(76.16±12.63)、(79.12±12.54)、(80.41±12.26)分],两组以上评分较治疗前均有明显提高,差异有统计学意义(P<0.05),且两组之间治疗后比较差异无统计学意义(P>0.05),而门诊随访组治疗3个月和6个月后各方面评分较治疗前均无明显差异(P>0.05),且与家庭康复组和住院康复组治疗后相比较差异有统计学意义(P<0.05)。在医疗费用支出情况方面,家庭康复组治疗3个月和6个月后分别为(567.71±93.45)、(427.59±84.58)元,门诊随访组分别为(328.79±43.94)、(342.79±37.58)元,均明显低于住院康复组[(13 222.74±1 136.56)、(11 253.84±938.54)元],差异有统计学意义(P<0.05)。结论家庭康复指导可有效的改善脑卒Objective To evaluate the influence of family rehabilitation on limb function and quality of life in patients after stroke and to compare family rehabilitation with inpatient rehabilitation and outpatient guidance. Methods Forty-five patients after stroke were randomly divided into three groups to receive family rehabilitation, inpatient rehabilitation, and outpatient guidance, respectively, with 15 cases in each group. All the three groups were given conventional comprehensive rehabilitation treatment. After hospital discharge, the family rehabilitation group was given training guidance for family rehabilitation, and the outpatient guidance group was followed on an outpatient basis once a month. At three and six months after treatment, the Fugl-Meyer Assessment（FMA）, the Modified Barthel Index（MBI）, and the MOS 36-item short from health survey（SF-36） were used for evaluations and comparisons. Average medical expense was also compared among the three groups. Results Before treatment, the FMA, MBI, and SF-36 scores in the three groups had no significant difference（P〉0.05）. At three and six months after treatment, the family rehabilitation group and inpatient rehabilitation group had significantly improved FMA, MBI, and SF-36 scores compared with the scores before treatment（P〈0.05）. There was no significant difference in the FMA, MBI, or SF-36 score between the family rehabilitation group [three months：（60.26±10.46）,（66.36±9.25）, and（62.55±12.95）; six months：（74.58±11.58）,（77.12±12.78）, and（79.52±11.32）, respectively] and the inpatient rehabilitation group [three months：（63.28±12.59）,（68.21±11.35）, and（79.52±11.32）; six months：（76.16±12.63）,（79.12±12.54）, and（80.41±12.26）, respectively]（P〉0.05）. After three or six months of treatment, the outpatient guidance group had no significant improvement with regard to the above three scores（P〉0.05）. There was a significant difference in the above three scores between the

关 键 词：脑卒中 生存质量 家庭康复 

分 类 号：R743.3[医药卫生—神经病学与精神病学]