影响脑卒中患者日常生活活动能力社区康复效果的相关因素

目的探讨影响脑卒中患者日常生活活动能力（ADL）社区康复效果的相关因素。方法202例脑卒中患者随机分为社区康复组103例和对照组99例，社区康复组进行康复治疗和随访，包括对高危因素的药物控制、康复治疗、卫生宣教、心理疏导等，对照组只进行随访。于入组时和治疗5个月后，应用巴氏指数（BI）、神经功能缺损量表及综合功能评定（FCA）中的认知项，对两组患者进行评定。将所有患者最后一次ADL评分作为因变量，分组情况、病程、高血压、高血脂、糖尿病、吸烟、发病部位、文化程度、性别、年龄、饮酒、睡眠质量、FCA认知功能（入组时）、FCA运动功能（入组时）、BI（入组时）、神经功能缺损程度评分（入组时）做为自变量，进行多元回归分析。结果分组情况、发病前是否饮酒、病程（入组时间早晚）、神经功能缺损评分及综合功能评分（运动功能和认知功能）与患者日后的ADL恢复存在相关性。结论早期社区康复治疗对提高脑卒中患者的ADL作用显著；认知障碍对患者的ADL有显著影响。

Influencial Factors of Activities of Daily Living for Stroke Patients in Community-based Rehabilitation

ObjectiveTo explore the related factors influencing effect of community-based rehabilitation (CBR) on activities of daily living (ADL) in stroke patients in.Methods202 stroke patients were randomly divided into the CBR group (n=103) and control group (n=99). The patients of the CBR group treated with rehabilitation and following-up including risk factors controlled with drug, rehabilitation, health education and mental treatment, those of the control group only treated by following-up. Before and five months after treatment, patients of two groups were assessed with Barthel Index (BI), clinical never function limitation score, cognitive item of Functional Comprehensive Assessment (FCA). Multielement regression analysis was applied, the ADL score of last assessment was taken as dependent variable, group information, location, smoking, sex, age, course of diseases, education, drinking, sleeping, the first scores of FCA and BI were taken as independent variable.ResultsThe improvement of ADL of stroke patients was related with group information, drinking, course of diseases, the first scores of FCA, BI, and etc.ConclusionEarly CBR can significantly improve the ADL of the stroke patients. Cognitive deficit also has influence on ADL.