季晓颖 蔡静芳（上海市闸北区宝山路街道社区卫生服务中心 上海 200071）

宝山社区脑卒中后遗症患者“四站式”康复服务效果分析

季晓颖 蔡静芳
（上海市闸北区宝山路街道社区卫生服务中心 上海 200071）

摘 要目的：探讨对脑卒中后遗症患者实施“四站式”康复服务的效果。方法：对2011年1月至2012年3月出院的缺血型脑卒中患者进行分层抽样，将宝山街道社区50例设为研究组，共和新路街道社区50例设为对照组。对照组不作特殊干预，只完成门诊常规治疗；研究组采用“四站式”康复服务，并分为群体干预和个体干预两部分。两组患者均在研究开始时和12个月结束时，采用Fugl-Meyer(FMA)量表评估患者康复功能，用改良巴氏指数（MBI）量表评估患者日常生活能力。同时对两组患者康复知识知晓度、康复项目利用率和康复服务满意度进行比较。结果：研究组干预后，在康复服务量、FMA评分、MBI评分、患者康复认知度和满意度等项目上均较对照组有明显提高。结论：“四站式”康复服务方案的应用，实现了病房、门诊、站点及家庭的社区全程管理，为更好地开展社区康复服务提供新的途径。

关键词脑卒中 后遗症 康复“四站式”服务

Analysis of the effect of the “four stops” rehabilitation services for the patients with the stroke sequelae in Baoshan Community

JI Xiaoying, CAI Jingfang
(Baoshanlu Community Health Service Center of Zhabei District, Shanghai 200071, China)

ABSTRACTObjective: To explore the effect of the “four stops” rehabilitation services on the patients with the stroke sequelae. Methods: The patients with the ischemic stroke who were discharged from the hospital from Jan. 2011 to March 2012 were classified by the stratified sampling, and 50 cases at the Baoshan Community were set as a study group and another 50 cases at Gonghexinlu Community as a control group. The special intervention was not given in the control group besides the outpatient conventional treatment while the “four stops” rehabilitation services that were in the study group further divided into two parts of the group and individual interventions. The two groups adopted Fugl-Meyer (FMA) scale to evaluate their rehabilitation function and the improved pap index (MBI) scale to evaluate their daily life ability at the start of the study and at the end of 12 months. Their awareness of the knowledge of rehabilitation, utilization rate of the rehabilitation project and satisfaction of rehabilitation service were compared at the same time. Results: The quantity of the rehabilitation service, scores of FMA and MBI, awareness of the rehabilitation, satisfaction and other index were improved more obviously in the study group than in the control group after the intervention. Conclusion: The application of the scheme of the “four stops” rehabilitation services realizes the community management of the whole process from the ward, outpatient clinic, station and home and provides the new way for the development of a better community rehabilitation service.

KEY WORDSstroke; sequelae; “four stops” rehabilitation services

脑卒中患者的致残率在70%~80%[1-2]，其中重度致残者占40%。社区康复专业医师缺乏，康复网络不健全，只有近10%的社区卫生中心独立注册康复医学科，绝大多数的社区卫生中心只将康复工作作为中医药服务的一部分，并且只提供门诊和站点的康复服务，病房和家庭康复服务几乎是空白。……