依托综合医院康复医学科对偏瘫病人进行社区康复的模式探索

目的探索基于综合医院康复医学科对偏瘫病人进行社区康复治疗的诊疗模式。方法选取崇州市各社区医疗机构接诊的偏瘫病人62例作为观察组，同期崇州市人民医院接诊的偏瘫病人48例作为对照组。对照组病人一直在医院康复中心进行系统性的康复治疗，观察组病人依托综合医院康复医学科对偏瘫病人进行社区康复。6个月后，采用简易Fugl-Meyer（FMA）量表、改良Barthel（BI）指数、汉密尔顿焦虑量表（HAMA）评价2组病人的治疗效果，并比较病人的康复治疗费用。结果康复前，2组病人的FMA、BI、HAMA评分差异均无统计学意义（P>0.05）。康复6个月后，2组FMA、BI评分均明显高于康复前（P < 0.01），HAMA评分均低于康复前（P < 0.05）；2组病人的FMA、BI评分差异均无统计学意义（P>0.05），观察组HAMA评分明显高于对照组（P < 0.01）。观察组康复治疗平均总费用为（24 674.8±3 861.2）元，明显低于对照组的（38 672.5±6 167.4）元（P < 0.01）。结论社区医院在综合医院的参与指导下共同管理偏瘫病人，对其进行身躯康复治疗是既经济又有效的，并对康复医疗体系的建设有促进作用。

Investigation of the community rehabilitation mode for hemiplegic patients relied on rehabilitation medicine of general hospital

ObjectiveTo explore the community rehabilitation mode for hemiplegic patients relied on rehabilitation medicine of general hospital.MethodsSixty-two hemiplegic patients from Chongzhou City community medical institutions and 42 cases from Chongzhou People's Hospital were divided into the observation group and control group, respectively.The control group was treated with systematic rehabilitation method in rehabilitation center of hospital, and the observation group was treated with the community rehabilitation mode relied on rehabilitation medicine of general hospital.After six months, the treatment effects in two groups were evaluated using the simple Fugl-Meyer(FMA) scale, improved Barthel index(BI), and Hamilton Anxiety Scale(HAMA), and the rehabilitation costs between two groups were compared.ResultsThere was no statistical significance in the scores of FMA, BI and HAMA between two groups before rehabilitation(P>0.05).After 6 months of rehabilitation, the scores of FMA and BI in two groups were significantly higher than those before treatment(P < 0.01), and the HAMA score in two groups were significantly lower than that before treatment(P < 0.05).The differences of the scores of FMA and BI between two groups were not statistically significant(P>0.05), and the score of HAMA in observation group was significantly higher than that in control group(P < 0.01).The average total cost of rehabilitation treatment in observation group(24 674.8±3 861.2)yuan] was significantly lower than that in control group(38 672.5±6 167.4)yuan](P < 0.01).ConclusionsUnder the guidance and co-management of general hospital, the physical rehabilitation treatment of hemiplegic patients in community hospitals is economic and effective, which can promote the construction of tertiary rehabilitation medical system.