【摘要】 目的:探讨影响脑血管偏瘫患者个体预后的因素,构建早期康复护理模式。方法:选择符合条件的脑血管病偏瘫患者122例,随机分为康复组60例和对照组62例,两组均接受神经内科常规治疗和一般护理,康复组在此基础上实施早期康复护理模式训练。分别于入院时、28d和90d时采用Fugle-Meyer运动功能评定,ADL功能状况的评定,采用国际通用的Barthel指数评定疗效。对可能影响脑血管病偏瘫患者个体预后的因素,做单因素分析和Logistic多元逐步回归分析;对两组实施早期康复护理模式后的Fugle-Meyer评分,Barthel指数进行比较。结果:单因素分析显示,影响脑血管病偏瘫患者个体预后的变量为:年龄(P<0.05)和多发性卒中(P<0.05);Logistic多元逐步回归分析显示,影响脑血管病偏瘫患者个体预后的变量为:年龄(P<0.05)、病灶部位(P<0.05)和多发性卒中(P<0.05)。经过28d、90d早期康复护理模式干预后,康复组Fugle-Meyer值有大幅度提高,明显优于对照组(P<0.05)。两组在干预前后28d及90d的Barthel指数比较差异有统计学意义(P<0.05)。结论:年龄、病灶部位、多发性卒中是影响脑血管病偏瘫患者个体预后的重要因素,同时对脑血管病偏瘫患者针对性的实施早期康复护理模式可明显改善患者的自理能力,提高其生活质量。更多还原

【Abstract】 Objective:To study the factors to affect the individual prognosis in order to find a early rehabilitation nursing model for the hemiplegia patients with cerebrovascular disease.Methods:122 eligible hemiplegia patients with cerebrovascular disease were randomly divided into rehabilitation group(n = 60) and control group(n = 62).The patients in both groups received conventional neurological treatment and nursing care.The patients in the rehabilitation group were given training by early rehabilitation nursing model on the basis of basic treatment and nursing care.The curative effect was assessed by internationally accepted Fugle-Meyer,ADL and Barthel Index when the patients were admitted,28 days and 90 days in the hospital respectively.The single-factor analysis and Logistic multiple regression analysis was made considering the factors which might affect the individual prognosis.Fugle-Meyer scores and Barthel Index were compared between the two groups after the implementation of early rehabilitation nursing model.Results:The single-factor analysis showed that the variables to affect the individual prognosis were age(P < 0.05) and multiple stroke(P < 0.05) ;Logistic multiple regression analysis showed that the variables were age(P < 0.05),lesion site(P < 0.05) and multiple stroke(P < 0.05).The Fugle-Meyer value was greatly improved and superior in the rehabilitation group to that in the control group after the intervention by early rehabilitation nursing model for 28 days and 90 days(P < 0.05) ;the comparison of Barthel index between the two groups was significantly different before and after the intervention(P < 0.05).Conclusion:The age,lesion location and multiple stroke are the main factors to affect the individual prognosis of hemiplegia patients with cerebrovascular disease,therefore early rehabilitation nursing model can improve self-care ability of the patients so as to improve their quality of life.更多还原