“全-专结合”社区康复模式对脑卒中运动功能预后影响研究  

“General-Specialized”community rehabilitation model and prognosis of motor function in stroke

作　　者：郁彬 刘利 李磊 曹平 刘玉旗 姜蓉 Yu Bin;Liu Li;Li Lei(General Practice Department of Songnan Community Health Service Center of Baoshan District,Shanghai 200441,China)

机构地区：[1]上海市宝山区淞南镇社区卫生服务中心全科医学科,上海200441 [2]上海市宝山区淞南镇社区卫生服务中心行政办公室,上海200441 [3]上海市杨浦区殷行社区卫生服务中心全科医学科,上海200438 [4]上海交通大学附属新华医院全科医学科,上海200092 [5]上海市第二康复医院康复医学科,上海200441

出　　处：《中国康复》2024年第7期444-448,共5页Chinese Journal of Rehabilitation

基　　金：2021上海市社区卫生协会社区科研面上项目(SWX21M08);2021上海市宝山区科学技术委员会医学卫生项目(21-E-31)。

摘　　要：目的:探讨应用“全-专结合”社区康复模式对初发脑卒中运动功能障碍患者预后的影响。方法:选取初发脑卒中且遗留有运动功能障碍患者100例,随机分为社区组和专科组各50例。专科组于上海市第二康复医院进行12个月的脑卒中运动功能康复,社区组患者出院后向下转诊至各社区康复中心,实施为期12个月的“全-专结合”社区康复模式干预。干预前后采用日常生活能力评分(ADL)、Fugl-Meyer量表(FMA)、Berg平衡量表(BBS)及改良Rankin量表评估患者运动功能,并评估2组患者的规律服药率、卒中复发率、卒中后相关月均费用、跌倒发生率以及知识、态度、行为(KAP)问卷评分。最终,社区组45例、专科组46例完成研究。结果:12个月后,2组患者ADL、FMA、BBS评分均较干预前增加(均P<0.01),改良Rankin评级较干预前降低(均P<0.01),2组间ADL、FMA、BBS评分及改良Rankin评级比较差异无统计学意义;社区组KAP分项得分和总分、规律服药率均高于专科组(均P<0.01),卒中复发率、卒中后相关月均费用均低于专科组(均P<0.05),2组患者跌倒发生率比较差异无统计学意义。结论:“全-专结合”社区康复模式可改善脑卒中患者运动功能障碍患者预后,与专科康复疗效相当,还可以提高患者的治疗依从性、降低卒中复发风险并减轻经济负担。Objective:To explore the prognostic impact of the application of a“General-Specialized”combination community rehabilitation model on patients with initial stroke and residual motor dysfunction.Methods:A total of 100 patients with initial stroke and residual motor dysfunction who visited Xinhua Hospital Affiliated to Shanghai Jiao Tong University,from September 2021 to November 2022 were selected and divided into a community rehabilitation group(50 cases)and a specialized rehabilitation group(50 cases).The specialized rehabilitation team conducted stroke motor function rehabilitation intervention for 12 months at Shanghai Second Rehabilitation Hospital,collecting general information and motor function related scales including Activities of Daily Living(ADL),Fugl Meyer assessment scale(FMA),Berg Balance scale(BBS),and modified Rankin scale.After discharge,patients in the community rehabilitation group were referred downwards to various community rehabilitation centers(Songnan Community Rehabilitation Center in Baoshan District and Yinhang Community Rehabilitation Center in Yangpu District)for a 12 month“General-Specialized”community rehabilitation intervention.The aforementioned scales,related prognosis,knowledge,attitude,and practice(KAP)scores within and between the two groups after 12 months of intervention were analyzed and compared.Results:The patients who completed the study were 45 in the community rehabilitation group and 46 in the specialized rehabilitation group.After intervention,the ADL,FMA,and BBS scores of the two groups were significantly higher than before intervention,while the modified Rankin score was significantly lower than before intervention(all P<0.01).After intervention,there was no statistically significant difference in the ADL,FMA,BBS scores,and modified Rankin scores between the two groups.After intervention,the KAP sub scores and to tal scores of the community rehabilitation group were significantly higher than those of the specialized rehabilitation group(all P<0.01).The regul

关 键 词：脑卒中 运动功能 病例对照研究 全-专结合 社区康复 

分 类 号：R49[医药卫生—康复医学] R743.3[医药卫生—临床医学]