综合性卒中单元对急性脑卒中患者近期预后的影响

关键词：急性脑卒中 综合性卒中单元 康复

Keywords:acute stroke  rehabilitation  combined stroke unit

摘要：

      目的：探讨综合性卒中单元对急性脑卒中患者近期预后的影响。方法：选综合性卒中单元的急性脑卒中患者206例为治疗组。神经科常规病房的急性卒中患者207例为对照组。比较两组主要临床指标。结果：治疗组21天感染发生率7．79％，病死率6.3％，其中非颅内病变死亡占30．8％，而对照组分别为17．4％、8．7％、61．1％，除病死率差异无显著性意义（P〉0．05）外，其他差异都具有显著性意义（P〈0．01）。两组21天神经功能评分差异无显著性意义（P〉0．05）。随访90天改良的Rankin积分两组差异具有显著性意义（P〈0．01）。结论：急性卒中患者可以从综合性卒中单元医疗模式中获益，并能提高非生活依赖和回归社会的比例。

Abstract:

      Objective: To evaluate the advantages of combined stroke unit for acute stroke patients in near future. Method: The data of 206 acute stroke patients managed within combined stroke unit(A) group were compared with that of 207 acute stroke patients treated in commonly neurological ward(B) group. The patients with hemiplegia were diagnosed by CT or MRI. Result:There were significant differences between A group and B group at 21days in the rate of infection(7.76% vs 17.4%), P<0.01. There were not significant differences between A group and B group at 21days in the rate of mortality(6.3% vs 8.7%),P>0.05.But there were significant differences between A group and B group in rate of no-cerebral causes for death (30.8% vs 61.1%),P<0.01. And also, the scores of Chinese Stroke Scale at 21 days were not significantly different between two groups,P>0.05. As well as Modified Rankin Scale at 90 days were significantly different between two groups, P<0.01.Conclusion:Combining acute and rehabilitation services in a Stroke Unit may reduce the rate of infection, may reduce the rate of no-cerebral causes for death and improve functional outcome of patients with acute stroke at 90d.