CAJ | 학술논문

目的探讨卒中单元与社区医疗服务结合模式对脑卒中患者临床疗效的影响.方法将120例脑卒中患者随机分成3组,分别是卒中单元+社区医疗组(简称联合组)、卒中单元组及普通治疗组.前2组患者在住院期间接受卒中单元模式治疗,普通治疗组仅给予常规内科治疗.出院后联合组患者通过社区医疗服务形式继续接受定期康复指导,卒中单元组仅进行随诊观察.分别于入选、出院时及出院3个月后采用Fugl-Meyer评分法评定肢体运动功能,采用Barthel指数(BI)评定日常生活活动(ADL)能力,采用抑郁自评量表(SDS)评定抑郁情绪,并对各组患者评定结果进行比较.结果 3组患者入选时,其肢体运动功能、ADL 能力及抑郁情绪组间差异均无统计学意义(P>0.05);出院时联合组、卒中单元组肢体运动功能及ADL能力均明显优于普通治疗组(P<0.05);出院3个月后,发现联合组、卒中单元组肢体运动功能及ADL能力均较出院时进一步改善,且以联合组的改善幅度较显著,与卒中单元组比较,组间差异具有统计学意义(P<0.05).3组患者出院时抑郁情绪无明显差异(P>0.05);出院3个月后联合组、卒中单元组抑郁情绪明显好转,且以联合组的改善幅度较显著,与卒中单元组比较,组间差异具有统计学意义(P<0.05).结论卒中单元与社区医疗服务结合模式对脑卒中患者肢体运动功能、ADL 能力及抑郁情绪具有显著改善作用,值得大力推广、应用.
목적 탐토졸중단원여사구의료복무결합모식대뇌졸중환자림상료효적영향.방법 장120례뇌졸중환자수궤분성3조,분별시졸중단원+사구의료조(간칭연합조)、졸중단원조급보통치료조.전2조환자재주원기간접수졸중단원모식치료,보통치료조부급여상규내과치료.출원후연합조환자통과사구의료복무형식계속접수정기강복지도,졸중단원조부진행수진관찰.분별우입선、출원시급출원3개월후채용Fugl-Meyer평분법평정지체운동공능,채용Barthel지수(BI)평정일상생활활동(ADL)능력,채용억욱자평량표(SDS)평정억욱정서,병대각조환자평정결과진행비교.결과 3조환자입선시,기지체운동공능、ADL 능력급억욱정서조간차이균무통계학의의(P>0.05);출원시연합조、졸중단원조지체운동공능급ADL능력균명현우우보통치료조(P<0.05);출원3개월후,발현연합조、졸중단원조지체운동공능급ADL능력균교출원시진일보개선,차이연합조적개선폭도교현저,여졸중단원조비교,조간차이구유통계학의의(P<0.05).3조환자출원시억욱정서무명현차이(P>0.05);출원3개월후연합조、졸중단원조억욱정서명현호전,차이연합조적개선폭도교현저,여졸중단원조비교,조간차이구유통계학의의(P<0.05).결론 졸중단원여사구의료복무결합모식대뇌졸중환자지체운동공능、ADL 능력급억욱정서구유현저개선작용,치득대력추엄、응용.
Objective To evaluate the clinical efficacy of a stroke unit combined with community health services for treating stroke survivors. Methods A total of 120 stroke patients were randomly divided into a " stroke unit combined with community medicine" group ( combined group) , a stroke unit group and a general treatment group. Patients in the former 2 groups were treated in a hospital stroke unit during their hospitali-zation. The general treatment group was given conventional medical treatment. After discharge, the combined group continued to receive regular rehabilitation therapy and guidance in the form of community medical services, while the stroke unit group received follow-up only. Assessment was by means of Fugl-Meyer scores, the Barthel index and self-rating on a depression scale ( SDS). The patients were assessed at admission, on discharge and 3 months after discharge. Results There were no significant differences in average limb motor function, ability in the activities of daily living ( ADL) or depressive mood among the 3 groups on admission, but at discharge, limb motor function and ADL ability in the combined group and stroke unit groups were significantly superior to those in the general therapy group. Limb motor function and ADL ability in the combined and stroke unit groups had improved further 3 months after discharge, with more significant improvements in the combined group. No significant change in depression was observed in any group at discharge, but average depression scores in the combined and stroke unit groups improved significantly in the 3 months after discharge, and there was a statistically significant difference between the combined group and the general group. Conclusion Supplementing the work of a stroke unit with community health services significantly improves stroke patients' recovery of limb motor function and ADL ability.