意识障碍恢复期康复临床路径实施效果初探  

Preliminary study on implementation effect of clinical rehabilitation pathway in the recovery stage of consciousness disorder

作　　者：杨力 康君伟 王珺[1] 周璐[1] 杜青[1] 方龙君 乐凯 刘玲玲[1] 董晓阳[1] 冯珍[1] YANG Li;KANG Junwei;WANG Jun(The First Affiliated Hospital of Nanchang University,Nanchang,Jiangxi,330006)

机构地区：[1]南昌大学第一附属医院康复医学科,江西省南昌市330006

出　　处：《中国康复医学杂志》2022年第12期1606-1610,共5页Chinese Journal of Rehabilitation Medicine

基　　金：国家自然科学基金项目(82160437、81860409);江西省重点研发计划重点项目(20202BBG72002);江西省科学技术厅临床应用研究培育计划(20212BAG70023)。

摘　　要：目的:制定并探讨意识障碍恢复期康复临床路径的实施效果。方法:意识障碍患者112例随机分为路径组(n=59),对照组(n=53)。路径组按照意识障碍恢复期康复临床路径方案诊疗,对照组按照常规方案诊疗。观察两组患者干预前后的行为学评分、意识状态等级改善状况、并发症发生率及日均住院费用等指标。结果:治疗后,两组患者行为学评分、意识状态等级改善率和觉醒率等指标较治疗前均有提高(P<0.05),且路径组优于对照组(P<0.05);路径组阵发性交感神经兴奋性增高发生率、日均住院总费用和药品费用等均少于对照组(P<0.05),脑积水、癫痫、肺部感染、尿路感染等并发症发生率以及两组日均康复治疗费用无显著性差异(P>0.05)。结论:意识障碍恢复期康复临床路径管理可提高意识障碍等级改善率及觉醒率,降低住院费用,减少并发症。Objective:To establish and explore the effect of clinical rehabilitation pathway in the convalescent consciousness disorder patients.Method:Totally 112 patients with disturbance of consciousness were randomly divided into path group(n=59)and control group(n=53).The path group received clinical rehabilitation path plan in the recovery stage of consciousness disorder,and the control group received routine plan.Behavioral scores,improvement of consciousness status,incidence of complications and daily hospitalization cost of the two groups were observed before and after intervention Result:After treatment,the behavioral scores,the improvement rate of consciousness level and the awakening rate of two groups were higher than those before treatment(P<0.05),and the path group was better than the control group(P<0.05).The incidence of paroxysmal sympathetic hyperactivity(PSH),total daily cost of hospitalization and drug cost in the path group were lower than those in the control group(P<0.05),and there was no significant difference in the incidence of hydrocephalus,epilepsy,pulmonary infection,urinary tract infection or other complications,as well as the average daily cost of rehabilitation between the two groups(P>0.05).Conclusion:The clinical rehabilitation pathway management in the recovery stage of consciousness disorder can improve the improvement rate of consciousness level and the awakening rate,reduce hospitalization cost and complications.

关 键 词：意识障碍 康复临床路径 住院费用 

分 类 号：R493[医药卫生—康复医学]