| 张盘德,刘鑫鑫,周惠嫦,黄文清,刘震,张薇平.脑梗死恢复期康复临床路径的实施和效果[J].中国康复,2017,32(5):390-393 |
| 脑梗死恢复期康复临床路径的实施和效果 |
| Implementation and effects of clinical rehabilitation pathway in the recovery stage of ischemic stroke |
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| DOI： |
| 中文关键词: 脑梗死 康复临床路径 日常生活能力 平均住院日 |
| 英文关键词: stroke clinical rehabilitation pathway activities of daily living length of hospital stay |
| 基金项目:佛山市科技局医学类科技攻关项目(2014AB00268)；科技创新平台建设项目（2016AG100421） |
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| 中文摘要: |
| 目的：制订脑梗死恢复期康复临床路径实施方案并评价其效果。方法：通过Delphi法制订脑梗死恢复期的康复临床路径。分析并比较2014年12月~2016年8月期间采用临床路径治疗的176例和2013年3月~2014年10月期间非临床路径治疗的142例脑梗死患者在住院时间、住院费用、日常生活活动（ADL）、Holden步行功能评分、手功能等方面的差异。结果：临床路径组的平均住院时间短于非临床路径组（P<0.05）；住院费用低于非临床路径组（P<0.05）。康复治疗后2组的ADL、Holden步行功能量表评分、手功能评分均比康复治疗前显著提高（P＜0.01），但2组组间比较差异均无统计学意义。临床路径延迟出院的负变异率22.1%（39/176）。结论：实施脑梗死恢复期康复临床路径可缩短住院时间，减少医疗费用，可以达到同样的康复效果。但在临床实施过程中变异率较高，仍需加以完善。 |
| 英文摘要: |
| Objective: To institute the implementation plan of clinical rehabilitation pathway on convalescent stroke patients and evaluate its efficacy. Methods: The rehabilitation clinical pathway was instituted on convalescent stroke patients according to Delphi method. Based on a retrospective study, the length of hospital stay, hospital expense and rehabilitation outcome (Activities of Daily Living in Barthel Index, Holden walking ability and hand ability) were compared between 176 convalescent stoke patients managed according to the clinical rehabilitation pathway and 142 stroke patients receiving traditional treatment. Results: The length of hospital stay in clinical pathway group (15.27±7.16 days) was significantly shorter than in the control group (17.16±9.51 days) (P=0.018). The hospital expense (15078.45±6893.69 CNY) in clinical pathway group was significantly less than in the control group (16238.15±9576.28 CNY) (P=0.027). What's more, rehabilitation outcome including Activities of daily living in Bathel Index, Holden walking ability and hand ability had no statistically significant difference between two groups. The variation rate of clinical pathway was 22.1% (39/176 cases) in clinical pathway group. Conclusions: The hospital expense was much less and the length of hospital stay was shorter in clinical pathway group than in the control group. Even then, clinical pathway group patients achieved the same rehabilitation outcome as the control group patients. However, there was a high variation rate in the clinical pathway group. It is necessary to optimize the clinical pathway before it is adapted into clinical practice. |
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