广州医科大学学报

目的:通过家庭病床服务实现的社区卒中单元康复管理模式改善脑梗死患者的生存质量。方法:120例患者分为门诊治疗组和家庭病床组,每组各60例。均予规范Ⅱ级预防、康复锻炼及相关疾病宣教、针灸治疗;家庭病床组由全科医师、全科护士上门对患者及家属进行康复锻炼及生活能力训练指导,监督服药及血压监测,管理膳食。比较入组后30、90 d两组患者运动及生活自理能力;1年后两组复发率,血压、血脂、血糖控制达标率,并发症发生率。结果:治疗90 d家庭病床组较门诊治疗组运动功能及生活自理能力有明显改善(P<0.05);1年后家庭病床组较门诊治疗组复发率、血压控制不达标率、并发症发生率明显减少(P<0.05)。结论:以家庭病床服务为中心的社区卒中单元康复管理是脑梗死患者康复的有效模式。

Objective: To investigate the efficacy of the community-based rehabilitation management model of stroke unit achieved by hospital at home service on improving the quality of life( QOL) in patients with cerebral infarction. Methods: A total of 120 patients were divided into outpatient treatment group and hospital at home group( n = 60 each). All patients received grade II standard prevention,rehabilitation exercise,related health education,and acupuncture and moxibustion treatment. Patients in the hospital at home group and their family members were guided by general doctors and nurses for rehabilitation exercise and living ability training.And patients in the hospital at home group were supervised for medication,monitored for blood pressure,and managed for diet. The exercise and self-care ability at 30 and 90 d after patients were included in the two groups were compared. Also,the recurrence rate,control rates of blood pressure,blood lipid and blood glucose,and occurrence rate of complications at 1 year in the two groups were compared. Results: The motor function and selfcare ability at 90 d after the treatment in the hospital at home group were significantly improved compared with those in the outpatient treatment group( P < 0. 05). The recurrence rate,blood pressure which did not meet the control rate,and occurrence rate of complications at 1 year significantly decreased compared with those in the outpatient treatment group( P < 0. 05). Conclusion: The community-based rehabilitation management model of stroke unit,focusing on hospital at home service,is an effective model for the rehabilitation of patients with cerebral infarction.