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目的 :介绍强化随访管理在中青年脑卒中患者延续护理中的应用并调查其效果。方法 :将250例中青年脑卒中患者随机分为对照组(n=125)和干预组(n=125),对照组患者出院后实施门诊随访和电话随访,干预组针对电话随访、门诊随访、入户随访、社区随访给予强化随访管理。比较出院后3个月、6个月、1年两组患者日常生活能力、终点事件发生率、照顾者负荷。结果 :出院后6个月、12个月时,干预组患者日常生活能力水平高于对照组,照顾者负荷低于对照组;干预期内,干预组终点事件发生率低于对照组,差异均有统计学意义(P<0.05)。结论 :强化随访管理能够提高中青年脑卒中患者出院后日常生活能力,降低脑卒中不良事件发生率和照顾者负荷水平。
OBJECTIVE: To introduce the application of intensive follow-up management in extended care of stroke patients in middle-aged and young adults and investigate its effect. Methods: 250 middle-aged and young stroke patients were randomly divided into control group (n = 125) and intervention group (n = 125). Patients in control group were outpatient follow-up and phone follow-up. Telephone intervention, Follow-up home, community follow-up to give enhanced follow-up management. After 3 months, 6 months and 1 year after discharge, the daily living ability, the incidence of end-point events and the burden of caregivers in both groups were compared. Results: At 6 months and 12 months after discharge, the daily living ability of the intervention group was higher than that of the control group, and the burden of caregivers was lower than that of the control group. During the intervention period, the incidence of end-point events in the intervention group was lower than that of the control group There was statistical significance (P <0.05). CONCLUSIONS: Intensive follow-up management can improve the daily living ability of stroke patients in middle-aged and young adults after discharge, and reduce the incidence of stroke-related adverse events and the load of caregivers.