基于老年综合评估的不同养老模式对脑卒中恢复期患者运动和认知功能康复效果影响  

Effects of different pension models based on comprehensive evaluation of the elderly on the rehabilitation of motor and cognitive functions in convalescent patients with stroke

作　　者：黄冬 李阳 张晓梅 杨荣军[1] 赵耀[1] 赵凯涛 梁军丽 成毅 王磊[1] 苗锐[1] Huang Dong;Li Yang;Zhang Xiaomei(Department of Neurology,Shaanxi Second People's Hospital,Xi'an 710005,China)

机构地区：[1]陕西省第二人民医院神经内科,西安710005

出　　处：《中华保健医学杂志》2022年第3期200-203,共4页Chinese Journal of Health Care and Medicine

基　　金：陕西省重点研发计划(2021SF-273)。

摘　　要：目的比较家庭养老、机构养老、医养护一体化社区居家养老3种模式对脑卒中恢复期患者运动、认知功能康复效果的影响。方法选取2018年1月~2021年1月于陕西省第二人民医院治疗出院的脑卒中患者及同期在医养结合试点社区非急性期脑卒中患者98例,根据养老方式分为家庭养老组(48例)、机构养老组(29例)、医养结合组(21例)。于入组时及6个月后采用Barthel指数(Barthel Index,BI)评估患者日常生活能力。采用Fugl-Meyer运动功能评分(Fugl Meyer motor function assessment,FMA)对老人运动功能进行评定。采用蒙特利尔认知评估量表对老人认知功能进行评定。结果入组时,3组BI评分、MoCA评分、FMA评分差异无统计学意义(P>0.05)。康复干预6个月后,3组上述评分均上升,家庭养老组和机构养老组BI评分、FMA评分与入组时比较,差异无统计学意义(P>0.05),医养结合组BI评分、FMA评分明显高于入组时,也高于同期家庭养老组和机构养老组,差异均有统计学意义(P<0.05)。3组的MoCA评分均高于入组时,差异均有统计学意义(P<0.05),机构养老组MoCA评分高于家庭养老组,医养结合组MoCA评分高于同期家庭养老组和机构养老组,差异均有统计学意义(P<0.05)。结论现阶段家庭养老和机构养老对于脑卒中恢复期患者运动和认知功能的恢复效果欠佳,与之相较,医养结合社区基于老年综合评估的精准干预可明显改善患者的运动和认知功能,提高其日常生活能力,且该模式符合国家政策,具有持续完善发展空间。Objective To compare the effects of three models of family pension,institutional pension and medical care integration community home pension on the rehabilitation of motor and cognitive function in convalescent patients with stroke.Methods Stroke patients discharged from our hospital from January 2018 to January 2021 and non acute stroke patients in the pilot community of medical and nursing combination of Shaanxi Normal University were selected.They were divided into family pension group,institutional pension group and medical and nursing combination group according to the mode of pension.At the time of enrollment and 6 months later,Barthel Index(BI)was used to evaluate the activities of daily living of the patients.The motor function of the elderly was evaluated by Fugl-Meyer motor function assessment(FMA).The cognitive function of the elderly was evaluated by Montreal cognitive assessment scale.Results There was no significant difference in BI score,MoCA score and FMA score among the three groups(P>0.05).After 6 months of rehabilitation intervention,the above scores of the three groups increased.There was no significant difference in BI scores and FMA scores between the family pension group and institutional pension group,P>0.05.The BI scores and FMA scores of the combined medical care group were significantly higher than those when they were enrolled,and also higher than those of the family pension group and institutional pension group in the same period,P<0.05.The MoCA scores of the three groups were higher than those of the enrollment group,and the differences were statistically significant(P<0.05).The MoCA scores of the institutional elderly care group were higher than those of the family elderly care group,and the MoCA scores of the combined medical care group were higher than those of the family elderly care group and the institutional elderly care group in the same period,and the differences were statistically significant(P<0.05).Conclusion At this stage,the effect of family pension and institutional pe

关 键 词：脑卒中 恢复期 运动功能 认知功能 家庭养老 医养结合 

分 类 号：R743.3[医药卫生—神经病学与精神病学]