“医院-社区-家庭”康复路径在缺血性脑卒中患者中的应用研究

  目的  探讨基于“医院-社区-家庭”康复路径在缺血性脑卒中患者中的应用效果。  方法  选取2019年1月—2020年4月徐州医科大学附属淮安医院收治的缺血性脑卒中患者120例，按照随机数字表法分为对照组和观察组各60例。对照组予传统康复管理，观察组予基于“医院-社区-家庭”康复路径管理。比较2组患者神经功能、肢体功能恢复情况、日常生活活动能力、生活质量、心理状态以及并发症发生情况。  结果  观察组患者的脑卒中神经功能缺损程度(21.12±2.32)分]低于对照组(27.81±4.33)分]，而简明精神状态得分高于对照组(21.14±5.65)分vs.(18.89±1.24)分]，均P < 0.05；观察组Fugl-Meyer肢体运动功能(39.49±5.38)分]高于对照组(33.67±4.02)分]，改良Barthel指数(77.17±8.20)分]高于对照组(65.17±9.21)分]，均P < 0.05；观察组脑卒中生存质量(164.65±18.76)分]高于对照组(110.76±21.83)分，P < 0.05]，而焦虑自评量表和抑郁自评量表评分低于对照组(P < 0.05)；干预期间观察组不良反应总发生率低于对照组(P < 0.05)。  结论  “医院-社区-家庭”康复路径可促进缺血性脑卒中患者的康复，提高生活质量，降低患者负面情绪和不良反应。 

Application of rehabilitation path based on linkage of hospital-community-family in patients with ischemic stroke

  Objective  To explore the application effect of rehabilitation path based on the linkage of hospital-community-family in patients with ischemic stroke.  Methods  A total of 120 patients with ischemic stroke admitted to our hospital from January 2018 to April 2020 were selected and randomly divided into the control group and observation group, with 60 cases each. The control group received traditional rehabilitation management, whilst the observation group received rehabilitation path management based on linkage of hospital-community-family. The nerve function, limb function recovery, activities of daily living, quality of life, mental state and complications of both groups were compared.  Results  The neurological deficits of stroke in the observation group (21.12±2.32) points] were lower than those in the control group (27.81±4.33) points], whilst the simple mental status score in the observation group was higher than that in the control group (all P < 0.05). The Fugl-Meyer limb movement function in the observation group (39.49±5.38) points] was higher than that in the control group (33.67±4.02) points]. Moreover, the modified Barthel index in the observation group (77.17±8.20) points] was higher than that in the control group (65.17±9.21) points, all P < 0.05]. The quality of life in the observation group after stroke (164.65±18.76) points] was higher than that in the control group (110.76±21.83) points, P < 0.05]. The scores of the anxiety self-rating scale and depression self-rating scale in the observation group were lower than those in the control group (P < 0.05). The incidence of complications in the observation group during the intervention period was lower than that in the control group (P < 0.05).  Conclusion  The rehabilitation path model based on the linkage of hospital-community-family can promote the recovery of patients with ischemic stroke after discharge, improve the quality of life and reduce the negative emotions and adverse reactions of patients.