胡静

【摘要】 目的：探讨“医护康一体化”延续性管理模式对脑卒中患者的干预效果。方法：选取2018年10月-2019年6月在本院治疗的90例脑卒中患者，采用随机方便抽样方法分为对照组和观察组，各45例，随访至2019年12月，共3例患者失访，观察组44例，对照组43例。对照组出院后给予常规随访，观察组实施“医护康一体化”延续性管理模式。对比两组干预前后神经功能、运动功能、日常生活能力、生活质量及护理满意度。结果：干预3、6个月后，观察组NIHSS评分均低于对照组（P<0.05）。干预1、3、6个月，观察组FMA评分均高于对照组（P<0.05）。干预1、3、6个月，观察组BI指数、SF-36评分均高于对照组（P<0.05）。观察组护理满意度得分高于对照组（P<0.05）。结论：“医护康一体化”延续性管理模式能够促进患者神经功能与运动功能的恢复，改善日常生活能力与生活质量，提高满意度。

【关键词】 医护康一体化 脑卒中 延续护理 生活质量 神经功能 满意度

Intervention Effect of “Medical Health Integration” Continuance Management Mode on Stroke Patients/HU Jing. //Medical Innovation of China， 2021， 18（12）： -110

[Abstract] Objective： To investigate the intervention effect of “medical health integration” continuance management mode on stroke patients. Method： A total of 90 stroke patients treated in our hospital from October 2018 to June 2019 were selected and divided into the control group and the observation group by random convenient sampling method， 45 cases in each group， follow-up was carried out to December 2019， a total of 3 patients were lost to follow-up， 44 cases in observation group and 43 cases in control group. The control group was given regular follow-up after discharge， the observation group implemented “medical health integration” continuance management mode. Nerve function， motor function， activity of daily living， quality of life， nursing satisfaction of two groups before and after intervention were compared. Result： At 3 and 6 months of intervention， the NIHSS score of the observation group were lower than those of the control group （P<0.05）. At 1， 3， 6 months of intervention，  the FMA scores of the observation group were higher than those of the control group （P<0.05）. At 1， 3， 6 months of intervention， the BI and SF-36 scores of the observation group were higher than those of the control group （P<0.05）. The nursing satisfaction score of the observation group was higher than that of the control group （P<0.05）. Conclusion： “Medical health integration” continuance management mode can promote the recovery of nerve function and motor function， improve patients daily life ability and quality of life， enhance nursing satisfaction.

[Key words] Medical health integration Stroke Continuing nursing Quality of life Nerve function Satisfaction

First-authors address： First Peoples Hospital of Fuzhou， Fuzhou 344000， China

doi：10.3969/j.issn.1674-4985.2021.12.025

脑卒中是病死率、致残率较高的循环系统疾病，是威胁人类健康与生命安全的第二大杀手[1]。静脉溶栓是缺血性脑卒中的标准治疗方案[2]，但治疗后1年内复发率高达20%以上[3]。因我国医疗资源紧张、社区康复服务相对滞后，多数脑卒中患者出院后主要由家属承担恢复期的护理[4]。在此背景下，延续护理干预对于提高脑卒中患者康复效果、降低疾病复发率具有重要意义[5]。但目前国内外关于脑卒中的临床研究主要关注溶栓前及溶栓期间的护理干预，而较少关注溶栓后的延续护理。医护康一体化是指临床医师、护士、康复师、营养师在平等、自主、合作的基础上，充分发挥各自的专业能力，通过积极沟通与协调，共同为患者提供高质量的医疗康复服务的管理模式[6]。本研究旨在探索一種适合脑卒中溶栓治疗患者的医护康一体化延续性管理模式，为患者提供医院、家庭全程无缝隙的延续护理，以促进患者术后康复，改善患者预后，现报道如下。……