不同养老模式对老年急性脑梗死患者认知功能及预后改善的影响  

Effects of different pension models on cognitive function and prognosis improvement in elderly patients with acute cerebral infarction

作　　者：黄冬 杨荣军[1] 梁军丽 张晓梅 李阳 赵凯涛 成毅 苗锐[1] HUANG Dong;YANG Rong-jun;LIANG Jun-li;ZHANG Xiao-mei;LI Yang;ZHAO Kai-tao;CHENG Yi;MIAO Rui(Department of Neurology,the Second People's Hospital of Shaanxi Province,Xi'an 710005,Shaanxi,CHINA)

机构地区：[1]陕西省第二人民医院神经内科,陕西西安710005

出　　处：《海南医学》2022年第3期288-291,共4页Hainan Medical Journal

基　　金：陕西省重点研发计划项目(编号:2021SF-273)。

摘　　要：目的探讨不同养老模式对老年急性脑梗死患者认知功能、预后改善的影响。方法随机选取2018年6月至2020年6月于陕西省第二人民医院治疗后病情稳定待出院的急性脑梗死患者280例,其中居家养老208例,社区养老43例,机构养老29例。患者出院接受3个月基于老年综合评估的不同模式养老后,采用简易精神状态量表(MMSE)评价患者认知功能,采用神经功能缺损程度评分、Fugl-Meyer肢体评分、Barthel指数、焦虑自评量表(SAS)、抑郁自评量表(SDS)、生活质量量表(SF-36)分别评价患者的神经缺损程度、肢体运动能力、独立生活能力、焦虑抑郁程度及生活质量。结果三种不同养老方式患者出院3个月后MMSE评分、神经功能缺损程度评分、Fugl-Meyer肢体评分、Barthel指数、SAS评分、SDS评分及SF-36各维度评分比较差异均有统计学意义(P<0.05);居家养老和社区养老患者的MMSE评分、Fugl-Meyer肢体评分、Barthel指数、SF-36各维度评分均明显高于机构养老患者,差异均有统计学意义(P<0.05),而居家养老与社区养老患者之间上述各指标比较差异均无统计意义(P>0.05);居家养老患者神经功能缺损程度评分、SAS评分、SDS评分分别为(9.36±1.12)分、(41.29±3.36)分、(40.37±3.12)分,社区养老患者分别为(9.62±1.20)分、(41.33±3.41)分、(40.61±3.25)分,两组患者均明显低于机构养老患者的(13.19±1.48)分、(45.62±3.87)分、(44.68±3.86)分,差异均有统计学意义(P<0.05),而居家养老与社区养老患者之间上述各指标比较差异均无统计意义(P>0.05)。结论基于老年综合评估下居家及社区养老模式相较于机构养老对老年急性脑梗死患者的认知功能及预后改善效果更为显著。Objective To explore the influence of different pension models on cognitive function and prognosis in elderly patients with acute cerebral infarction.Methods A total of 280 patients with acute cerebral infarction in stable conditions to be discharged from the Second People's Hospital of Shaanxi Province from June 2018 to June 2020 were randomly selected,including 208 cases of home based care,43 cases of community based care,and 29 cases of institutional care.The cognitive function of the patients were evaluated by Mini-Mental State Examination(MMSE)after 3 months of discharge in different models based on comprehensive geriatric assessment.The neurological deficit score,Fugl-Meyer limb score,Barthel index,self-rating anxiety scale(SAS),self-rating depression scale(SDS),and quality of life scale(SF-36)were used to evaluate the degree of neurological deficit,limb movement ability,independent living ability,anxiety and depression,and quality of life of patients,respectively.Results There were statistically significant differences in MMSE score,neurological deficit score,Fugl-Meyer limb score,Barthel index,SAS score,SDS score and SF-36 score among patients with three different pension methods after discharge 3 months(P<0.05).The MMSE score,Fugl-Meyer limb score,Barthel index,and SF-36 score of patients with home based care and community based care were significantly higher than those of patients with institutional care(P<0.05).There were no statistically significant differences in the above indicators between home based care and community based care(P>0.05).The scores of neurological deficit,SAS,and SDS of home-based care were(9.36±1.12)points,(41.29±3.36)points,(40.37±3.12)points,and those of community based care were(9.62±1.20)points,(41.33±3.41)points and(40.61±3.25)points,respectively,which were significantly lower than(13.19±1.48)points,(45.62±3.87)points and(44.68±3.86)points of institutional care;the differences were statistically significant(P<0.05).There were no statistically significant differences

关 键 词：老年急性脑梗死 老年综合评估 养老模式:认知功能 预后 

分 类 号：R743.33[医药卫生—神经病学与精神病学]