陈睿+郁艳+蒋石益

摘 要 目的：探讨社区开展康复活动对于脑卒中患者肢体功能康复的影响。方法：选取2014年4至10月参与社区“陈睿健康工作室”康复活动的脑卒中恢复期患者50例作为观察组，选取同期延吉社区卫生服务中心门诊的50例脑卒中恢复期患者作为对照组（进行门诊随访、服药、自我康复）。采用知识、信念、行为（KAP）量表对观察组患者进行问卷调查。采用简化Fugl-Meyer肢体运动功能评分表（Fugl-Meyer assessment of motor function，FAM）比较两组患者入组时和入组6个月时的肢体功能恢复情况及对家庭医生（门诊医师）的满意度。结果：入组6个月时，两组患者的FAM均有所改善，观察组FAM得分[上肢（50.92±7.05）分，下肢（33.01±1.37）分]较对照组[上肢（34.85±6.55）分，下肢（25.20±4.88）分]更高，差异有统计学意义（t上肢=11.821 5，t下肢=10.859 5，P均<0.01）。观察组患者的满意率为92%（46/50），明显高于对照组的30%（15/50，P<0.05）。结论：在社区开展康复活动可以促进脑卒中患者肢体功能的康复，提高患者的满意度。

关键词 脑卒中 肢体功能 社区康复

中图分类号：R743.3 文献标识码：A 文章编号：1006-1533（2016）04-0057-03

Observation of the effect of the community comprehensive rehabilitation in the stroke patients in the recovery stage

CHEN Rui， YU Yan， JIANG Shiyi

（Yanji Community Health Service Center of Yangpu District， Shanghai 200093， China）

ABSTRACT Objective： To explore the influence of the community development of the rehabilitation activity on the limb function rehabilitation of the stroke patients. Methods： Fifty cases of the stroke in the recovery stage who participated in the rehabilitation activity of “Chen Rui health working room” from April to Oct. 2014 were selected as an observation group and 50 cases of the stroke in the recovery stage in the clinic of Yanji Community Health Service Center as a control group and given the following-up in the clinic， medication and self rehabilitation. The scale questionnaire for the knowledge， attitude and practice（KAP） was administered to the patients in the observation group. The functional recovery of the limb function and the satisfaction for the family doctors （ physicians in the outpatient clinic） were compared with the simplified Fugl-Meyer assessment of motor function （FMA） between two groups when they were just selected into the groups and after 6 months intervention. Results： After six months， the scores of FMA in two groups were improved. The scores of FMA of the upper and lower limbs were （50.92±7.05） and （33.01±1.37） in the observation group， which were higher than （34.85±6.55） and （25.20±4.88） in the control group， and the differences had the statistical significance （tupper limb =11.821 5， tlower limb=10.859 5， both P<0.01）. The patients satisfaction was 92%（46/50） in the observation group， which was higher than 30% （15/50） in the control group （P<0.05）. Conclusion： Development of the rehabilitation activity in the community can promote the rehabilitation of the limb function of the stroke patients and improve the patients satisfaction.

KEY WORDS stroke； limb function； community rehabilitation

脑卒中是严重威胁人类健康的常见病，发病率和致残率均较高，严重影响患者生活质量[1]。2014年延吉社区卫生服务中心对所辖内江社区的脑卒中恢复期患者进行知识、信念、行为（knowledge attitude practice，KAP）量表调查，并进行肢体功能康复及健康干预，现报道如下。

1 对象与方法

1.1 一般资料

采取方便抽样法，选取2014年4月至10月内江团队社区脑卒中肢体功能障碍患者50例为观察组，其中男29例，女21例，年龄62～84岁，平均年龄（72.45±4.71）岁，均为脑卒中恢复期患者。其中脑卒中后3个月～3年29例，3年以上21例；无合并症10例，有1种合并症17例，有2种以上合并症23例。选取同期延吉社区卫生服务中心内科门诊的脑卒中肢体功能障碍患者50例作为对照组，其中男性27例，女性为23例，年龄55～84，平均年龄为（63.0±4.7）岁，均为脑卒中恢复期患者。……