缺血性脑卒中患者三级康复应用PEO模式的效果研究  

Research on the application of three-level rehabilitation combined with PEO model in patients with ischemic stroke

作　　者：孙娟娟[1] 左蝶 田瑞思 杨秀红[1] 朱爱丽[1] 李萍[1] SUN Juanjuan;ZUO Die;TIAN Ruisi;YANG Xiuhong;ZHU Aili;LI Ping(The Second Affiliated Hospital of Xinjiang Medical University,Urumqi 830063,China;College of Nursing,Xinjiang Medical University,Urumqi 830017,China)

机构地区：[1]新疆医科大学第二附属医院,乌鲁木齐830063 [2]新疆医科大学护理学院,乌鲁木齐830017

出　　处：《新疆医科大学学报》2023年第11期1542-1546,共5页Journal of Xinjiang Medical University

基　　金：新疆维吾尔自治区自然科学基金项目(2021D01C357)。

摘　　要：目的探讨在缺血性脑卒中患者三级康复训练中,在人-环境-作业(Person-environment-occupation,PEO)模式指导下为脑卒中患者进行有效治疗,并观察其疗效。方法选取2022年1月至2022年12月期间在本院神经诊疗中心诊治的缺血性脑卒中患者254例作为研究对象。将患者随机分为干预组和对照组,各127例。对照组在三级康复医疗机构实施统一的康复治疗;干预组则在对照组措施的基础上,加入PEO理论指导下以患者为中心的基础性日常生活活动能力训练实践模式,两组患者在三级综合医院神经内科入院时、二级康复中心的第4周、一级社区康复训练的第8周以及第16周时,采用神经功能缺损程度量表(China Stroke Scale,CSS)和Barthel指数评定量表(Barthel Index,BI)来评估两组患者训练前后的神经功能和日常生活能力变化情况。结果两组患者在年龄、性别、体质指数、吸烟、高血压、高血脂症、糖尿病、冠心病、房颤、甘油三酯、总胆固醇、低密度脂蛋白、高密度脂蛋白、血尿素氮、血肌酐、梗死灶数量、首诊NIHSS评分方面的差异无统计学意义(P均>0.05)。两组患者在三级综合医院神经内科入院时、二级康复中心的第4周的CSS评分和Barthel指数评分差异无统计学意义(P均>0.05)。干预组在一级社区康复训练的第8周以及第16周时CSS评分较对照组明显降低,Barthel指数评分较对照组升高,差异有统计学意义(P均<0.05)。结论在缺血性脑卒中患者三级康复管理路径中应用PEO理论指导模式,能够有效改善缺血性脑卒中患者神经功能和日常生活能力,值得临床推广与应用。Objective To explore the effective treatment of patients with ischemic stroke under the guidance of Person-environment-occupation(PEO)mode in three-level rehabilitation training,and observe its curative effect.Methods From January 2022 to December 2022,254 patients with ischemic stroke were selected as the research object.Patients were randomly divided into intervention group and control group with 127 patients in each group.The control group implemented unified rehabilitation treatment in tertiary rehabilitation medical institutions.On the basis of the control group's measures,the intervention group added the patient-centered basic activity of daily living training practice mode under the guidance of PEO theory.When the patients in the two groups were admitted to the neurology department of a tertiary general hospital,the fourth week of the secondary rehabilitation center,the eighth week and the sixteenth week of the first-level community rehabilitation training,the neurological function and daily life of the patients in the two groups were evaluated by the China Stroke Scale(CSS)and the Barthel Index(BI)before and after training.Results There was no significant difference between the two groups in age,sex,body mass index,smoking,hypertension,hyperlipidemia,diabetes,coronary heart disease,atrial fibrillation,triglyceride,total cholesterol,low density lipoprotein,high density lipoprotein,blood urea nitrogen,serum creatinine,the number of infarcts and the first NIHSS score(P>0.05).There was no significant difference in CSS score and Barthel index score between the two groups at the time of admission to the neurology department of the third-level general hospital and the fourth week of the second-level rehabilitation center(P>0.05).The CSS score of the intervention group was significantly lower than that of the control group at the 8th week and 16th week of the first-class community rehabilitation training,and the Barthel index score was higher than that of the control group,with statistical significance(P<0.05).Co

关 键 词：缺血性脑卒中 PEO模式 三级康复 功能康复 

分 类 号：R49[医药卫生—康复医学]