脑卒中康复治疗远期预后相关多因素分析

目的 探讨脑卒中患者康复治疗远期预后与多种相关因素之间的关系。方法 入选的104例住院急性期脑卒中患者病情稳定后开始Bobath康复训练，出院后继续在社区医院或者家中进行康复训练，在康复训练前及康复训练后6个月分别行Fugl-Meyer运动评分（FMA）和改良Barthel指数（MBI）评分，并记录患者发病前及治疗期间各种相关影响因素，应用多因素Logistic回归分析方法分析患者远期预后与各种相关因素之间的关系。结果 患者入院时的病情严重程度、认知状态、抑郁、家庭支持状况等4种因素是运动功能和日常生活活动能力评分的独立影响因素，小便失禁和年龄也是日常生活活动能力评分的独立影响因素（P〈0．05）。结论 多种相关因素对康复治疗的远期疗效造成影响，有效改善患者的认知功能、抑郁状态和加强家庭支持将有助于脑卒中患者的预后。

Analysis of multiple factors correlated with the long-term prognosis of stroke patients receiving a rehabilitation program

Objective To analyze factors which could affect the long-term prognosis of stroke patients treated with a rehabilitation program. Methods A total of 104 patients with acute stroke were included in this study. All were treated with a Bobath rehabilitation program beginning in hospital as soon as the patient's condition had stabilized, and followed by a rehabilitation program in a community health center or at home after discharge from the hospital for 6 months. Fugl-Meyer Assessment and the Modified Barthel Index scores were assessed before and 6 months after rehabilitation treatment, and various related factors were recorded. The relationship between each patient's prognosis and the related factors was analyzed through multinomial logistic regression. Results Four factors: state on admission, cognition, depression, and familial support level were found to be significantly correlated with motor function and ADL scores after rehabilitation. Incontinence and age were significantly correlated only with the ADL score. Conclusion Certain factors predict the long-term prognosis of stroke patients receiving rehabilitation. Interventions aimed at improving the patients'cognition and depression as well as strengthening the patients' family support would benefit patients' long-term prognoses.