本文選題：臨床路徑 + 腦卒中��； 參考：《中國(guó)康復(fù)醫(yī)學(xué)雜志》2017年09期

【摘要】：目的:從臨床功能角度評(píng)估缺血性腦卒中社區(qū)康復(fù)臨床路徑康復(fù)方案的效果,為腦卒中社區(qū)康復(fù)臨床路徑的優(yōu)化和推廣提供數(shù)據(jù)支持。方法:采用隨機(jī)、單盲、平行對(duì)照、多中心的前瞻性研究,符合納入標(biāo)準(zhǔn)的缺血性腦卒中患者247例,隨機(jī)分為臨床路徑組(129例)和常規(guī)康復(fù)組(118例)。臨床路徑組進(jìn)入社區(qū)康復(fù)臨床路徑并執(zhí)行相應(yīng)康復(fù)治療方案,常規(guī)康復(fù)組采取常規(guī)康復(fù)治療,不進(jìn)入臨床路徑,對(duì)康復(fù)治療內(nèi)容及時(shí)間不做要求。主要結(jié)局指標(biāo)采用改良Barthel指數(shù)(MBI)及次要結(jié)局指標(biāo)Fugl-Meyer運(yùn)動(dòng)功能評(píng)分量表(FMA)對(duì)兩組患者ADL能力、綜合功能水平、運(yùn)動(dòng)功能進(jìn)行評(píng)定和分析。結(jié)果:臨床路徑組康復(fù)治療前后的MBI差值、MBI改善程度均顯著高于常規(guī)康復(fù)組,差異有顯著性意義(P0.05)。兩組患者康復(fù)治療前后FMA差值及FMA改善程度比較,差異有顯著性意義(P0.05)。結(jié)論:社區(qū)康復(fù)臨床路徑結(jié)合規(guī)范化的康復(fù)方案能提高缺血性腦卒中患者的ADL能力,改善患者的功能。
[Abstract]:Objective: to evaluate the effect of community rehabilitation in ischemic stroke from the point of view of clinical function so as to provide data support for optimizing and popularizing the clinical pathway of community-based rehabilitation of stroke. Methods: a randomized, single-blind, parallel controlled, multicenter prospective study was conducted in 247 patients with ischemic stroke, who were randomly divided into two groups: the clinical pathway group (n = 129) and the routine rehabilitation group (n = 118). The clinical pathway group entered the community rehabilitation clinical path and carried out the corresponding rehabilitation treatment plan. The routine rehabilitation group took routine rehabilitation treatment and did not enter the clinical path. The content and time of rehabilitation treatment were not required. The main outcome indexes were modified Barthel index (MBI) and secondary outcome index (Fugl-Meyer motor function scale) to evaluate and analyze the ADL ability, comprehensive functional level and motor function of the two groups. Results: the difference of MBI before and after rehabilitation in the clinical pathway group was significantly higher than that in the routine rehabilitation group (P 0.05). The difference of FMA and FMA between the two groups before and after rehabilitation treatment was significant (P 0.05). Conclusion: the clinical pathway of community rehabilitation combined with standardized rehabilitation program can improve the ability of ADL and improve the function of patients with ischemic stroke.
【作者單位】： 南京醫(yī)科大學(xué)第一附屬醫(yī)院;無錫市同仁(國(guó)際)康復(fù)醫(yī)院;徐州市中心醫(yī)院;天津醫(yī)科大學(xué)總醫(yī)院;南通大學(xué)醫(yī)學(xué)院附屬醫(yī)院;南京醫(yī)科大學(xué)附屬江寧醫(yī)院;紹興市人民醫(yī)院;徐州醫(yī)科大學(xué)附屬醫(yī)院;蘇州大學(xué)第一附屬醫(yī)院;濱州醫(yī)學(xué)院附屬醫(yī)院;
【基金】：江蘇省臨床醫(yī)學(xué)科技專項(xiàng)項(xiàng)目(BL2012029)
【分類號(hào)】：R493;R743.3

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