【摘要】：目的探討基于區(qū)域醫(yī)療聯(lián)合體的腦卒中社區(qū)康復(fù)模式干預(yù)效果。方法建立以上海市第五人民醫(yī)院康復(fù)醫(yī)學(xué)科為核心,聯(lián)合閔行區(qū)6家社區(qū)衛(wèi)生服務(wù)中心的區(qū)域醫(yī)療聯(lián)合體。選取2012年6月—2015年6月到該6家社區(qū)衛(wèi)生服務(wù)中心就診的腦卒中患者105例。根據(jù)就診社區(qū)衛(wèi)生服務(wù)中心是否有康復(fù)治療師,將患者分為對照組(無康復(fù)治療師,n=52)和干預(yù)組(有康復(fù)治療師,n=53)。對照組患者僅進(jìn)行常規(guī)藥物治療,允許自行康復(fù)訓(xùn)練;干預(yù)組患者在常規(guī)藥物治療的基礎(chǔ)上,采用基于區(qū)域醫(yī)療聯(lián)合體的腦卒中社區(qū)康復(fù)模式進(jìn)行干預(yù)。分別于干預(yù)前及干預(yù)3、6個月后,采用Fugl-Meyer運動功能評定量表(FMA)、Barthel指數(shù)(BI)評價兩組患者的干預(yù)效果。結(jié)果兩組患者性別、平均年齡、平均病程、病變性質(zhì)比較,差異無統(tǒng)計學(xué)意義(P0.05)。兩組患者FMA、BI評分比較,差異有統(tǒng)計學(xué)意義(P0.05);不同時間點比較,差異有統(tǒng)計學(xué)意義(P0.05);干預(yù)方法和時間在FMA、BI評分上存在交互作用(P0.05)。干預(yù)前兩組患者FMA、BI評分比較,差異無統(tǒng)計學(xué)意義(P0.05);干預(yù)3、6個月后干預(yù)組患者FMA、BI評分高于對照組,差異有統(tǒng)計學(xué)意義(P0.05)。結(jié)論基于區(qū)域醫(yī)療聯(lián)合體的腦卒中社區(qū)康復(fù)模式可以有效提高腦卒中患者的運動功能和日常活動能力,有利于改善患者的生活質(zhì)量,幫助其重返家庭和社會。
[Abstract]:Objective to explore the intervention effect of community rehabilitation model of stroke based on regional medical association. Methods A regional medical association with 6 community health service centers in Minhang District was established with rehabilitation medicine department of Shanghai Fifth people's Hospital as the core. 105 stroke patients who visited the 6 community health service centers from June 2012 to June 2015 were selected. According to whether there was a rehabilitation therapist in the community health service center, the patients were divided into control group (no rehabilitation therapist, n = 52) and intervention group (with rehabilitation therapist, n = 53). The patients in the control group were only treated with routine drug therapy and self-rehabilitation training was allowed, while the patients in the intervention group were intervened by community rehabilitation model of stroke based on regional medical union on the basis of routine drug treatment. Before intervention and 3 months and 6 months after intervention, Fugl-Meyer motor function rating scale (FMA), Barthel index (BI) was used to evaluate the intervention effect of the two groups. Results there was no significant difference in sex, average age, average course of disease and nature of pathological changes between the two groups (P 0.05). The difference of FMA,BI score between the two groups was statistically significant (P 0.05), and the difference was statistically significant at different time points (P 0.05). There was interaction between intervention methods and time in FMA,BI score (P 0.05). There was no significant difference in FMA,BI score between the two groups before intervention (P 0.05). After 6 months of intervention, the FMA,BI score of the intervention group was higher than that of the control group, the difference was statistically significant (P 0.05). Conclusion the community rehabilitation model of stroke based on regional medical union can effectively improve the motor function and daily activity ability of stroke patients, help to improve the quality of life of patients, and help them to return to family and society.
【作者單位】： 復(fù)旦大學(xué)附屬上海市第五人民醫(yī)院康復(fù)醫(yī)學(xué)科;上海市閔行區(qū)江川社區(qū)衛(wèi)生服務(wù)中心;上海市閔行區(qū)古美社區(qū)衛(wèi)生服務(wù)中心;上海市閔行區(qū)吳涇社區(qū)衛(wèi)生服務(wù)中心;上海市閔行區(qū)馬橋社區(qū)衛(wèi)生服務(wù)中心;上海市閔行區(qū)顓橋社區(qū)衛(wèi)生服務(wù)中心;上海市閔行區(qū)梅隴社區(qū)衛(wèi)生服務(wù)中心;
【基金】：上海市衛(wèi)生和計劃生育委員會科研課題項目(20114325)——區(qū)域康復(fù)醫(yī)療聯(lián)合體運營模式初探
【分類號】：R743.3
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本文編號：2516464