Barthel指数对脑卒中患者住院康复效果的预测

目的：探讨Barthel指数(BI)对脑卒中患者治疗前后功能状态改变的预测效果。方法：采用回顾性研究的方法．将脑卒中患者227例的临床资料进行分析。根据患者入院时BI积分，分为严重功能障碍组、重度功能障碍组、中度功能障碍组、轻度功能障碍组和功能良好组。应用BI评定患者康复治疗前和出院时的日常生活活动能力。结果：入院时中度功能障碍患者的平均BI增分和增分速率均明显高于其他各组。提示BI积分41～60的脑卒中患者可作为住院康复治疗的首选对象．并可初步预测患者经过康复治疗后可能获得良好康复效果。结论：中度功能障碍患者比重度及轻度功能障碍患者具有更高的功能获得。

Prognostication of Effectiveness of Rehabilitation in Stroke by Barthel Index

Objective:To study the prognostication of the functional change by Barthel index (BI) in the patients with stroke before and after treatment. Methods:Multivariate analysis was performed on data collected retrospectively from 227 stroke patients who had received the BI assessment at admission and at discharge and underwent inpatient rehabilitation treatment. Seven independent variables were obtained from patients' medical records. The patients were stratified into 5 groups according to their BI total scores at admission: very severely affected patient group, severely affected patient group, moderately affected patient group, mildly affected patient group and good function patient group. Results: Moderately affected patients at admission showed significantly higher functional gain compared with severely or mildly affected patients. However, there was no significant difference in age, gender, site and properties of lesion. Conclusion:The functional levels of affected patients on admission, as stratified by the BI scores, can roughly predict the degree of functional gain from intensive rehabilitation. These findings may be useful for rehabilitation triage.