缺血性脑卒中社区康复临床路径的疗效研究:多中心、单盲、随机对照前瞻性研究

目的:从临床功能角度评估缺血性脑卒中社区康复临床路径康复方案的效果,为脑卒中社区康复临床路径的优化和推广提供数据支持。方法:采用随机、单盲、平行对照、多中心的前瞻性研究,符合纳入标准的缺血性脑卒中患者247例,随机分为临床路径组(129例)和常规康复组(118例)。临床路径组进入社区康复临床路径并执行相应康复治疗方案,常规康复组采取常规康复治疗,不进入临床路径,对康复治疗内容及时间不做要求。主要结局指标采用改良Barthel指数(MBI)及次要结局指标Fugl-Meyer运动功能评分量表(FMA)对两组患者ADL能力、综合功能水平、运动功能进行评定和分析。结果:临床路径组康复治疗前后的MBI差值、MBI改善程度均显著高于常规康复组,差异有显著性意义(P0.05)。两组患者康复治疗前后FMA差值及FMA改善程度比较,差异有显著性意义(P0.05)。结论:社区康复临床路径结合规范化的康复方案能提高缺血性脑卒中患者的ADL能力,改善患者的功能。

The effect of community rehabilitation clinical pathway on functional recovery in patients with ischemic stroke

Abstract Objective: To investigate the effect of clinical pathway in community on functional recovery for patients with ischemic stroke. Method: A total of 247 patients with ischemic stroke were randomized into clinical pathway group and conventional rehabilitation group. Patients in the clinical pathway group were treated according to specific rehabilitation program, while the conventional rehabilitation group received routine rehabilitation program. Modified Barthel index (MBI) and the Fugl-Meyer motor assessment scale (FMA) were performed separately before and after clinical pathway intervention. Result: The difference of MBI between pre-treatment and post-treatment and percent of MBI improvement in the clinical pathway group were significantly higher than those in the conventional group (P<0.05). The FMA''s difference and FMA improvement after treatment between the clinical pathway and the conventional group also elevated obviously than the conventional group (P<0.05). Conclusion: Community rehabilitation clinical pathway combined with standard rehabilitation program can effectively improve the ability of daily living and motor function of ischemic patients.