社区康复对脑卒中后遗症期老年住院患者的干预效果研究  

Research of intervention effect of community rehabilitation on elderly hospitalized patients with post-stroke sequelae

作　　者：陈云峰 张晓红 窦晓语 魏颖俊 CHEN Yunfeng;ZHANG Xiaohong;DOU Xiaoyu;WEI Yingjun(Medical Department,Department of Gaojing Community Health Service Center of Baoshan District,Shanghai 200435,China;Administrative Office,Department of Gaojing Community Health Service Center of Baoshan District,Shanghai 200435,China;Rehabilitation,Department of Gaojing Community Health Service Center of Baoshan District,Shanghai 200435,China;Respiratory and Critical Care Rehabilitation Department of Shanghai Second Rehabilitation Hospital,Shanghai 200441,China)

机构地区：[1]上海市宝山区高境镇社区卫生服务中心医务科,上海200435 [2]上海市宝山区高境镇社区卫生服务中心行政办公室,上海200435 [3]上海市宝山区高境镇社区卫生服务中心康复科,上海200435 [4]上海市第二康复医院呼吸与危重病康复科,上海200441

出　　处：《上海医药》2024年第14期53-57,共5页Shanghai Medical & Pharmaceutical Journal

基　　金：上海市宝山区医学卫生项目(2023-E-55);上海市宝山区(2023-2025)医学特色品牌建设计划(BSZK-2023-T07)。

摘　　要：目的:调查对社区卫生服务中心全科病区内脑卒中后遗症期老年患者进行社区康复干预的效果,为基层医疗机构更好地开展社区三级康复治疗提供参考。方法:随机将纳入研究的90例脑卒中后遗症期患者分为调查组和对照组各45例。总疗程为4周,对照组采取常规的医疗和护理措施,调查组在此基础上接受康复训练。治疗前后采用改良barthel指数(BI)、简易智能/心理精神评估表(MMSE)、Fugl-Meyer平衡功能量表、Fugl-Meyer关节活动度和感觉评测量表、Brunnstrom分级、洼田饮水试验等进行评定。结果:治疗后两组的改良barthel指数评分、Fugl-Meyer平衡功能评定量表、Brunnstrom分级、洼田饮水试验评分的差异均无统计学意义(均P>0.05)。治疗后调查组的Fugl-Meyer关节活动度和感觉量表和MMSE量表评分均高于对照组,差异均有统计学意义(均P<0.05)。结论:社区康复可改善全科病区内脑卒中后遗症期老年患者的认知功能和关节活动度和感觉评分。应加快社区康复中心建设,并有针对性地开展康复治疗训练,有利于老年脑卒中后遗症期患者日常生活能力和生存质量的改善。Objective:To investigate the community rehabilitation intervention effect on elderly patients with post-stroke sequelae in general wards of the community health service center,and to provide reference for grassroots medical institutions to carry out community three-level rehabilitation treatment well.Methods:Ninety patients with post-stroke sequelae who were included in the study were randomly divided into an investigation group and a control group with 45 cases each,and a total treatment period was 4 weeks.The control group received routine medical and nursing care,and the investigation group received rehabilitation training on this basis.Before and after treatment,the modified Barthel index(BI),mini-mental state examination(MMSE),Fugl-Meyer balance function scale,Fugl-Meyer joint range of motion and sensory evaluation scale,Brunnstrom grading and Wada drinking water test,etc.were used for evaluation.Results:There were no statistically significant differences in the modified Barthel index score,Fugl-Meyer balance function assessment scale,Brunnstrom grading,and Wada drinking water test scores between the two groups after treatment(P>0.05).After treatment,Fugl Meyer joint range of motion and sensory scale,and MMSE scale scores in the investigation group were higher than those in the control group,and the difference was statistically significant(P<0.05).Conclusion:Community rehabilitation can improve cognitive function,joint range of motion and sensory score of the elderly patients with post-stroke sequelae in general wards.The construction of community rehabilitation center should be accelerated,and the targeted rehabilitation treatment training is conducted,which is beneficial for improving the daily living ability and quality of life of elderly patients with post-stroke sequelae.

关 键 词：脑卒中后遗症期 老年人 社区康复 

分 类 号：R743.3[医药卫生—神经病学与精神病学]