卒中单元管理模式对脑卒中患者疗效的综合评估

目的:探讨卒中单元管理模式对脑卒中患者的疗效。方法:对2007年7月至2008年12月收住我院卒中单元502例脑卒中患者的疗效进行评估,与同时收住我院神经内科普通病房的624例脑卒中患者比较,比较两组住院期病死率、复发率、并发症、平均住院时间、平均住院费用、神经功能评价(national institutes of health stroke scale,NIHSS)、生活能力评价(Barthelindex,BI)、患者及家属的满意度及发病后3个月时卒中复发率、病死率及BI。结果:卒中单元和普通病房住院的脑卒中患者入院时一般情况、危险因素、卒中类型、入院时卒中严重程度等方面的比较无显著性的差异;住院期间卒中单元组患者肺部感染、尿路感染及深静脉血栓(DVT)发生率均低于普通病房组,两组比较有显著性的差异,P<0.05;两组患者入院时NIHSS评分和BI评分无显著性差异,治疗3~4周后两组患者的NIHSS评分均有降低,BI评分均有增高,但以卒中单元组患者改变更为明显,两组比较有显著性差异(P<0.05);卒中单元组患者住院期及发病后3个月病死率、复发率、生活活动能力(BI指数)、患者及家属的满意度均优于普通病房组患者(P<0.05),而平均住院时间和平均住院费用的比较两组无显著性的差异。结论:卒中单元管理模式能降低脑卒中患者的并发症、病死率和复发率,提高脑卒中患者

The Curative Effect of Stroke unit Management Model on Stroke Patients

Objective To explore the curative effect of stroke unit management model on stroke patients. Methods The mortality, relapse rate, complication, average time of hospitalization, average costs of hospitalization, neurological fimctions evaluation（national institutes of health stroke scale, NIHSS）, capacity assessment of life （ Barthel index, BI）, the satisfaction degree of patients and their families during hospitalization, and the relapse rate, mortality, BI after three month＇ s hospitalization were compared between 502 patients in the stroke unit management model and 624 patients in general ward during July 2007 to December 2008. Results There was no significant difference in general situation, risk factors, the types of stroke, the severity of stroke on admission between the two groups. During hospitalization, the incidence of lung infection, urinary infection and deep venous thrombosis was significantly lower in patients in stroke unit than those in general ward （ P 〈 0.05） ; There was no significant difference in NIHSS scores and BI scores on admission between two groups. After hospitalization of 3 - 4 weeks, NIHSS scores dropped and BI scores increased in two groups, but the patients in the stoke unit changed more obviously, there was a significant difference between the two groups （P 〈 0.05）; The mortality, relapse rate, capacity of life （ BI index）, satisfaction degree of patients and their families during hospitalization were better in patients in stoke unit than those in general ward , but there was no significant difference in the average time of hospitalization, average hospital cost between the two groups. Conclusion Stroke unit management model could reduce complication, mortality, relapse rate in stoke patients, and could also improve the curative effect in stoke patients.