文章摘要
魏海棠,杨珺,刘志霞,徐兆勇,杨丹,赵强,彭涛.三级康复体系对脑卒中患者功能障碍恢复的影响[J].中国康复,2014,29(1):8-11
三级康复体系对脑卒中患者功能障碍恢复的影响
Effects of Three-Stages Rehabilitation on dysfunction recovery in stroke patients
  
DOI:
中文关键词: 脑卒中  三级康复体系  功能障碍恢复
英文关键词: stroke  three-stages rehabilitation  dysfunction recovery
基金项目:
作者单位
魏海棠 汉口医院康复医学科武汉 430000 
杨珺 汉口医院康复医学科武汉 430000 
刘志霞 汉口医院康复医学科武汉 430000 
徐兆勇 汉口医院康复医学科武汉 430000 
杨丹 汉口医院康复医学科武汉 430000 
赵强 汉口医院康复医学科武汉 430000 
彭涛 汉口医院康复医学科武汉 430000 
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中文摘要:
  目的:探讨应用三级康复体系对脑卒中患者临床神经功能及ADL的影响,为脑卒中患者制定最佳康复方案。方法:将入选病例随机分为研究组(给予一、二、三级康复治疗)和2个对照组:一二级康复组(给予一级+二级康复治疗)和一三级康复组(给予一级+三级康复治疗)。 所有患者急性期在我院神经内科进行急诊临床治疗,病情稳定后早期介入康复治疗。研究组恢复期转入我院康复中心接受康复治疗,维持期转往社区维持康复治疗;一二级康复组恢复期在我院行康复治疗,维持期回家自行锻炼;一三级康复组病情稳定后从神经内科直接转往卫生服务中心行康复治疗。所有患者分别于入选时、第2、6、12周末及第6个月末,进行神经功能缺损程度评分(CSS)、运动功能评定(FMA)及日常生活能力(ADL)评定。结果:在第6、12周末及第6个月末,研究组CSS评分降低较对照组更显著(P<0.05);研究组及一二级康复组FMA和ADL评分增加较一三级康复组更显著(P<0.05);研究组肺部感染、泌尿系感染及肩手综合征并发率显著低于对照组(P<0.05)。结论:三级康复体系可以使脑卒中患者获得更好的运动功能、日常生活活动能力,提高生活质量,减少并发症,对患者的功能恢复具有积极促进作用,值得推广应用。
英文摘要:
  Objective:To discuss the effects of three-stages rehabilitation on the clinical neurologic deficit score (CSS),motor function and activities of daily living (ADL) of stroke patients,and develop the best rehabilitation programs in order to allocate medical resources rationally.Methods:All the patients were devided into research group (three-stages rehabilitation group) and two control groups (one-stage+two-stage rehabilitation group,one-stage+three-stage rehabilitation group). All patients in the acute phase received clinical treatments in the department of neurology of our hospital,and early rehabilitation would be intervened when the patients' conditions were stable.The patients in the three-stages rehabilitation group were transferred to the department of rehabilitation medicine for treatment in recovery period,then transferred to the Jinqiao community health service center which belongs to our hospital to receive treatment continually in maintenance phase.The patients in one stage+two-stage rehabilitation group received rehabilitation treatments in our hospital in recovery period and had self-exercise at home in maintenance phase.The patients in one-stage+three-stage rehabilitation group were transferred to the Jinqiao community health service center to receive rehabilitation treatments from the department of neurology as soon as the patients' conditions were stable.All patients were assessed with CSS,motor function and ADL at the time being selected and at the end of 2 weeks,6 weeks,12 weeks and 6 months.Results:At the end of 6 weeks,12 weeks and 6 months,CSS scores were significantly reduced,and FMA and ADL scores were significantly increased in research group as compared with control groups (P<0.05).The incidence of complications in research group was lower (P<0.05).Conclusion:Three-Stages Rehabilitation could help stoke patients to obtain better motor functions and ADL,improve quality of life (QOL) and reduce complications,and it played a positive role to promote dysfunction recovery of patients.
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