郑芳+金岙连+孙连儿

[摘要] 目的 分析醫养一体化护理模式对老年卒中后遗症期患者康复的影响。 方法 选择我院2014年3月～2015年12月收治的150例老年卒中后遗症期患者作为本次的研究对象，分为常规组与实验组，每组均75例患者。常规组患者采取一般护理模式，实验组患者采取医养一体化护理模式，对比两组的护理效果。 结果 护理前两组患者ADL评分无明显差异（P>0.05），护理后12个月实验组评分明显高于常规组（P<0.05）；护理前两组患者抑郁评分无明显差异（P>0.05），护理后实验组评分明显低于常规组（P<0.05）；随访期间，实验组2例患者复发，复发率为2.67%（2/75），常规组8例患者复发，复发率为10.67%（8/75），实验组卒中复发率明显低于常规组（P<0.05）。实验组与常规组平均医疗服务费用分别为（53355.26±1992.33）元与（57145.22±1785.23）元，实验组费用略低，两组费用无显著性差异（P>0.05）。 结论 对老年卒中后遗症期患者采取医养一体化护理模式的应用效果显著，可有效改善患者不良情绪，提高日常生活能力，促进疾病的早日康复。

[关键词] 老年；卒中后遗症期；康复；医养一体化

[中图分类号] R473.4 [文献标识码] B [文章编号] 1673-9701（2017）08-0157-04

[Abstract] Objective To analyze the effect of integrated medical care model on rehabilitation of elderly patients with stroke sequelae. Methods 150 cases of elderly patients with stroke sequelae in our hospital from March 2014 to December 2015 were selected as the study subjects. They were divided into two groups including the conventional group and the experimental group， with 75 cases in each group. The patients in conventional group was treated with the general care model， and the the patients in experimental group was used integrated medical care model.The nursing effects between the two groups were compared. Results There were no significant differences in ADL scores between the two groups before care（P>0.05）. The ADL score of the experimental group was significantly higher than that of the conventional group at 12 months after treatment （P<0.05）. There was no significant difference in depression scores between the two groups before treatment（P>0.05）. And the depression score of the experimental group was significantly lower than that of the conventional group after treatment（P<0.05）. There were 2 patients with recurrence in the experimental group through follow-up， and the recurrence rate was 2.67%（2/75）. While there were 8 patients with recurrence in the conventional group through follow-up，and the recurrence rate was 10.67% （8/75）， indicating that the recurrence rate in the experimental group was significantly lower than that in the conventional group（P<0.05）. The average cost of medical treatment in the experimental group and the conventional group was（53355.26±1992.33） and（57145.22±1785.23） respectively. The cost of the experimental group was slightly lower， and there was no significant difference between the two groups（P> 0.05）. Conclusion The application effect of taking the integrated medical care model is significant for elderly patients with stroke sequelae.It can effectively improve the negative emotions of patients and ability of daily life and improve the early recovery of the disease.

[Key words] Elderly； Stroke sequelae； Rehabilitation； Medical care integration

近些年来，随着社会老龄化程度的加剧，导致老年卒中的发病率逐年递增，虽然在急性期患者通过积极的临床干预可挽救其生命，但是多数患者仍然存在后遗症[1，2]。有关研究指出[3，4]，75%左右的老年卒中患者存在不同程度的劳动能力丧失情况，导致患者身心健康与日常生活能力受到了严重的影响，增加了患者的痛苦，给患者家庭、社会带来了沉重的负担。所以对老年卒中后遗症期患者采取积极有效的临床干预的意义重大，其中医养一体化护理模式属于一类新型的医养结合护理模式，可集养老、护理、医疗、康复、生命关怀、心理关爱为一体[5]。为对该类护理模式的应用效果进行更加深入的临床分析，本文将相关资料总结如下。