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目的观察脑梗死患者社区康复治疗的可行性和有效性。方法将2011年3月前登记在册和2011年3月-2012年9月新入组的脑梗死患者(285例)随机分为康复组(142例)和对照组(143例);由二级综合医院神经内科和康复科的专科医师对社区医院的医师进行脑梗死康复的理论、实践培训;社区医师负责入组患者的康复治疗1年。结果康复组和对照组患者入组时在神经功能缺损评分、日常生活能力评分、焦虑量表、抑郁量表评分方面差异无统计学意义(P>0.05);入组6个月后各量表评分两组差异有统计学意义(P<0.05),12个月后差异更加显著(P<0.01),康复组均优于对照组;洼田饮水试验结果在入组6个月时即出现明显差异(P<0.05),康复组吞咽功能优于对照组。结论社区康复治疗能明显减轻脑梗死患者躯体功能和心理功能的残疾程度,全面提高患者的生活质量,助其回归社会。二级综合医院联合社区医院是实现三级神经康复的有效途径。
Objective To observe the feasibility and effectiveness of community rehabilitation in patients with cerebral infarction. Methods A total of 285 patients with cerebral infarction who were enrolled before March 2011 and March 2011 to September 2012 were randomly divided into rehabilitation group (142 cases) and control group (143 cases) Hospital neurology and rehabilitation specialist for community hospital physicians for cerebral infarction rehabilitation theory and practice; community physicians responsible for the rehabilitation of patients in the group for 1 year. Results There was no significant difference in neurological deficit score, daily living ability score, anxiety scale and depression scale between the rehabilitation group and the control group when they were enrolled in the study group (P> 0.05). After 6 months of enrollment, The difference between the two groups was statistically significant (P <0.05), after 12 months the difference was more significant (P <0.01), rehabilitation group were better than the control group; Kudzu water test results in the group 6 months when the obvious (P <0.05). The swallowing function of rehabilitation group was better than that of control group. Conclusion Community rehabilitation can significantly reduce the degree of disability of physical and mental function in patients with cerebral infarction, improve the quality of life of patients and help them return to society. Second-level general hospital combined with community hospital is an effective way to achieve tertiary neurological rehabilitation.