缺血性脑卒中社区康复临床路径的疗效研究:多中心、单盲、随机对照前瞻性研究

发布时间：2018-05-04 18:47

本文选题：临床路径 + 脑卒中　；参考：《中国康复医学杂志》2017年09期

【摘要】：目的:从临床功能角度评估缺血性脑卒中社区康复临床路径康复方案的效果,为脑卒中社区康复临床路径的优化和推广提供数据支持。方法:采用随机、单盲、平行对照、多中心的前瞻性研究,符合纳入标准的缺血性脑卒中患者247例,随机分为临床路径组(129例)和常规康复组(118例)。临床路径组进入社区康复临床路径并执行相应康复治疗方案,常规康复组采取常规康复治疗,不进入临床路径,对康复治疗内容及时间不做要求。主要结局指标采用改良Barthel指数(MBI)及次要结局指标Fugl-Meyer运动功能评分量表(FMA)对两组患者ADL能力、综合功能水平、运动功能进行评定和分析。结果:临床路径组康复治疗前后的MBI差值、MBI改善程度均显著高于常规康复组,差异有显著性意义(P0.05)。两组患者康复治疗前后FMA差值及FMA改善程度比较,差异有显著性意义(P0.05)。结论:社区康复临床路径结合规范化的康复方案能提高缺血性脑卒中患者的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.
【作者单位】：南京医科大学第一附属医院;无锡市同仁(国际)康复医院;徐州市中心医院;天津医科大学总医院;南通大学医学院附属医院;南京医科大学附属江宁医院;绍兴市人民医院;徐州医科大学附属医院;苏州大学第一附属医院;滨州医学院附属医院;
【基金】：江苏省临床医学科技专项项目(BL2012029)
【分类号】：R493;R743.3

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