社区康复对脑出血偏瘫患者功能恢复的促进作用

发布时间：2018-06-27 00:48

本文选题：社区康复 + 脑出血　；参考：《南华大学》2014年硕士论文

【摘要】：目的脑出血是一种具备高死亡率、高复发率、高致残率特征并严重影响人类生存质量的疾病。社区康复是在社区与家庭两个层面上，为残疾人提供的康复服务。本研究旨在观察社区康复治疗对脑出血偏瘫患者服药依从性、整体功能及生活质量的影响，探索一种对脑出血偏瘫患者行之有效的社区康复模式。方法收集120例已出院的脑出血偏瘫患者，按照随机数字表法分为对照组（n=60）和康复组（n=60），对照组采取常规内科治疗与健康教育的方法，在此基础上，干预组实施社区康复治疗，干预时间均为6个月。在干预后6个月末，比较两组患者服药依从性。在入组时（干预前）以及干预后3个月末、6个月末采用临床神经功能缺损程度评分量表（NIM）、功能综合评定量表（FCA）、改良Barthel指数评定量表（MBI）及生活质量综合评定问卷（GQOL-74）对两组患者进行评价。结果 1.在干预过程中，对照组失访5例，失访率为8.33%，康复组失访3例，失访率为5.00%，两组失访率比较，差异无显著性（χ2=1.69, P0.05） 2.康复组干预后6个月末服药依从率明显高于对照组，差异有显著性（χ2=9.57, P 0.05）。 3.对照组干预后6个月末NIM评分低于干预前（P0.05），但干预后3个月末无影响（P0.05）；康复组干预后3个月末、6个月末NIM评分均较干预前减少（P0.01），且干预后6个月末NIM评分低于3个月末（P0.01）；两组干预前NIM评分比较，差异无显著性（P0.05），但康复组干预后3个月末、6个月末NIM评分明显低于同期对照组（P0.05,0.01）。 4.对照组干预后6个月末运动功能评分高于干预前（P0.05），但干预后3个月末无影响（P0.05）；康复组干预前后运动功能评分逐渐升高，各时间点之间的差异均有显著性（P0.05或0.01）；两组干预前运动功能评分的差异无显著性（P0.05），但康复组干预后3个月末、6个月末运动功能评分较同期对照组增加（P0.05）。 5.对照组干预后6个月末FCA评分较干预前增加（P0.05），但干预后3个月末无影响（P0.05）；康复组干预前后FCA评分呈逐渐升高趋势，且相互之间比较，差异均有显著性（P0.05或0.01）；两组干预前FCA评分相比，差异无统计学意义（P0.05），然而，，康复组干预后3个月末、6个月末FCA评分显著高于同期对照组（P0.05）。 6.对照组干预后6个月末MBI评分明显高于干预前（P0.05），但干预后3个月末无影响（P0.05）；康复组干预前后MBI评分逐渐升高，且各时间点之间比较，差异均有显著性（P0.05或0.01）；两组患者干预前MBI评分比较，差异无显著性（P0.05），但康复组干预后3个月末、6个月末MBI评分明显高于对照组同期（P0.05）。 7.两组患者干预前躯体功能、心理功能、社会功能、物质生活以及总体生活质量GQOL-74评分比较，差异均无显著性（P0.05）；康复组干预后3个月末、6个月末GQOL-74各维度得分显著高于同期对照组（P0.05）。结论社区康复有助于提高脑出血偏瘫患者的服药依从性，促进神经功能恢复，并改善生活质量。
[Abstract]:Objective intracerebral hemorrhage is a disease with high mortality, high recurrence rate, high disability rate and serious impact on human quality of life. Community rehabilitation is a rehabilitation service for the disabled at both community and family level. The purpose of this study was to observe the effects of community rehabilitation on drug compliance, overall function and quality of life of hemiplegic patients with cerebral hemorrhage, and to explore an effective community rehabilitation model for hemiplegic patients with cerebral hemorrhage. Methods 120 patients with cerebral hemorrhage hemiplegia who had been discharged from the hospital were randomly divided into two groups: control group (n = 60) and rehabilitation group (n = 60). The control group received routine medical treatment and health education. On the basis of this, the intervention group was treated with community rehabilitation. The intervention time was 6 months. At the end of 6 months after intervention, the compliance of the two groups was compared. Clinical Neurologic impairment scale (NIM), functional Comprehensive Assessment scale (FCA), modified Barthel Index scale (MBI) and quality of Life questionnaire (GQOL-74) were used at the time of entry (before intervention) and at the end of 3 months and 6 months after intervention. Two groups of patients were evaluated. Result 1. In the course of intervention, there were 5 cases in the control group and 8.33% in the control group, and 3 cases in the rehabilitation group and 5.00% in the rehabilitation group. There was no significant difference between the two groups (蠂 2, 1.69, P0.05). The compliance rate of rehabilitation group at the end of 6 months after intervention was significantly higher than that of control group (蠂 2 9.57, P 0.05). In the control group, the NIM score at the end of 6 months after intervention was lower than that before intervention (P0.05), but there was no effect at the end of 3 months after intervention (P0.05), and the NIM score of rehabilitation group at the end of 3 months and 6 months after intervention was lower than that before intervention (P0.01), and the score of NIM at the end of 6 months after intervention was lower than that before intervention (P0.01). There was no significant difference in NIM score between the two groups before intervention (P0.05), but the NIM score of rehabilitation group was significantly lower than that of control group at the end of 3 months and 6 months after intervention (P0.05 卤0.01). The motor function score of the control group was higher at the end of 6 months than that of before intervention (P0.05), but had no effect at the end of 3 months after intervention (P0.05), and the score of motor function in rehabilitation group increased gradually before and after intervention, and the difference between each time point was significant (P0.05 or 0.01). There was no significant difference in motor function score between the two groups before intervention (P0.05), but the motor function score of rehabilitation group increased at the end of 3 months and 6 months after intervention compared with that of control group (P0.05). In the control group, the FCA scores increased at the end of 6 months after intervention (P0.05), but had no effect at the end of 3 months after intervention (P0.05), and the scores of FCA in rehabilitation group increased gradually before and after intervention, and there were significant differences between the two groups (P0.05 or 0.01). There was no significant difference in FCA score between the two groups before intervention (P0.05), however, the FCA score of rehabilitation group was significantly higher than that of control group at the end of 3 months and 6 months after intervention (P0.05). The MBI scores in the control group were significantly higher at the end of 6 months than before (P0.05), but had no effect at the end of 3 months after intervention (P0.05), and the scores of MBI in the rehabilitation group increased gradually before and after intervention, and there were significant differences between the two groups (P0.05 or 0.01). There was no significant difference in MBI score between the two groups before intervention (P0.05), but the MBI score of rehabilitation group was significantly higher than that of control group at the end of 3 months and 6 months after intervention (P0.05). There was no significant difference in the scores of physical function, psychological function, social function, material life and overall quality of life between the two groups before intervention (P0.05). The scores of each dimension of GQOL-74 in rehabilitation group were significantly higher than those in control group at the end of 3 and 6 months after intervention (P0.05). Conclusion Community rehabilitation can improve the compliance of patients with cerebral hemorrhage and hemiplegia, promote the recovery of nerve function and improve the quality of life.
【学位授予单位】：南华大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.34

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