本文選題：社區(qū)康復 + 腦出血　； 參考：《南華大學》2014年碩士論文

【摘要】：目的腦出血是一種具備高死亡率、高復發(fā)率、高致殘率特征并嚴重影響人類生存質(zhì)量的疾病。社區(qū)康復是在社區(qū)與家庭兩個層面上，為殘疾人提供的康復服務。本研究旨在觀察社區(qū)康復治療對腦出血偏癱患者服藥依從性、整體功能及生活質(zhì)量的影響，探索一種對腦出血偏癱患者行之有效的社區(qū)康復模式。 方法收集120例已出院的腦出血偏癱患者，按照隨機數(shù)字表法分為對照組（n=60）和康復組（n=60），對照組采取常規(guī)內(nèi)科治療與健康教育的方法，在此基礎上，干預組實施社區(qū)康復治療，干預時間均為6個月。在干預后6個月末，比較兩組患者服藥依從性。在入組時（干預前）以及干預后3個月末、6個月末采用臨床神經(jīng)功能缺損程度評分量表（NIM）、功能綜合評定量表（FCA）、改良Barthel指數(shù)評定量表（MBI）及生活質(zhì)量綜合評定問卷（GQOL-74）對兩組患者進行評價。 結(jié)果 1.在干預過程中，對照組失訪5例，失訪率為8.33%，康復組失訪3例，失訪率為5.00%，兩組失訪率比較，差異無顯著性（χ2=1.69, P0.05） 2.康復組干預后6個月末服藥依從率明顯高于對照組，差異有顯著性（χ2=9.57, P 0.05）。 3.對照組干預后6個月末NIM評分低于干預前（P0.05），但干預后3個月末無影響（P0.05）；康復組干預后3個月末、6個月末NIM評分均較干預前減少（P0.01），且干預后6個月末NIM評分低于3個月末（P0.01）；兩組干預前NIM評分比較，差異無顯著性（P0.05），但康復組干預后3個月末、6個月末NIM評分明顯低于同期對照組（P0.05,0.01）。 4.對照組干預后6個月末運動功能評分高于干預前（P0.05），但干預后3個月末無影響（P0.05）；康復組干預前后運動功能評分逐漸升高，各時間點之間的差異均有顯著性（P0.05或0.01）；兩組干預前運動功能評分的差異無顯著性（P0.05），但康復組干預后3個月末、6個月末運動功能評分較同期對照組增加（P0.05）。 5.對照組干預后6個月末FCA評分較干預前增加（P0.05），但干預后3個月末無影響（P0.05）；康復組干預前后FCA評分呈逐漸升高趨勢，且相互之間比較，差異均有顯著性（P0.05或0.01）；兩組干預前FCA評分相比，差異無統(tǒng)計學意義（P0.05），然而，，康復組干預后3個月末、6個月末FCA評分顯著高于同期對照組（P0.05）。 6.對照組干預后6個月末MBI評分明顯高于干預前（P0.05），但干預后3個月末無影響（P0.05）；康復組干預前后MBI評分逐漸升高，且各時間點之間比較，差異均有顯著性（P0.05或0.01）；兩組患者干預前MBI評分比較，差異無顯著性（P0.05），但康復組干預后3個月末、6個月末MBI評分明顯高于對照組同期（P0.05）。 7.兩組患者干預前軀體功能、心理功能、社會功能、物質(zhì)生活以及總體生活質(zhì)量GQOL-74評分比較，差異均無顯著性（P0.05）；康復組干預后3個月末、6個月末GQOL-74各維度得分顯著高于同期對照組（P0.05）。 結(jié)論社區(qū)康復有助于提高腦出血偏癱患者的服藥依從性，促進神經(jīng)功能恢復，并改善生活質(zhì)量。
[Abstract]:Objective intracerebral hemorrhage is a disease with high mortality, high recurrence rate, high disability rate and serious impact on human quality of life. Community rehabilitation is a rehabilitation service for the disabled at both community and family level. The purpose of this study was to observe the effects of community rehabilitation on drug compliance, overall function and quality of life of hemiplegic patients with cerebral hemorrhage, and to explore an effective community rehabilitation model for hemiplegic patients with cerebral hemorrhage. Methods 120 patients with cerebral hemorrhage hemiplegia who had been discharged from the hospital were randomly divided into two groups: control group (n = 60) and rehabilitation group (n = 60). The control group received routine medical treatment and health education. On the basis of this, the intervention group was treated with community rehabilitation. The intervention time was 6 months. At the end of 6 months after intervention, the compliance of the two groups was compared. Clinical Neurologic impairment scale (NIM), functional Comprehensive Assessment scale (FCA), modified Barthel Index scale (MBI) and quality of Life questionnaire (GQOL-74) were used at the time of entry (before intervention) and at the end of 3 months and 6 months after intervention. Two groups of patients were evaluated. Result 1. In the course of intervention, there were 5 cases in the control group and 8.33% in the control group, and 3 cases in the rehabilitation group and 5.00% in the rehabilitation group. There was no significant difference between the two groups (蠂 2, 1.69, P0.05). The compliance rate of rehabilitation group at the end of 6 months after intervention was significantly higher than that of control group (蠂 2 9.57, P 0.05). In the control group, the NIM score at the end of 6 months after intervention was lower than that before intervention (P0.05), but there was no effect at the end of 3 months after intervention (P0.05), and the NIM score of rehabilitation group at the end of 3 months and 6 months after intervention was lower than that before intervention (P0.01), and the score of NIM at the end of 6 months after intervention was lower than that before intervention (P0.01). There was no significant difference in NIM score between the two groups before intervention (P0.05), but the NIM score of rehabilitation group was significantly lower than that of control group at the end of 3 months and 6 months after intervention (P0.05 鹵0.01). The motor function score of the control group was higher at the end of 6 months than that of before intervention (P0.05), but had no effect at the end of 3 months after intervention (P0.05), and the score of motor function in rehabilitation group increased gradually before and after intervention, and the difference between each time point was significant (P0.05 or 0.01). There was no significant difference in motor function score between the two groups before intervention (P0.05), but the motor function score of rehabilitation group increased at the end of 3 months and 6 months after intervention compared with that of control group (P0.05). In the control group, the FCA scores increased at the end of 6 months after intervention (P0.05), but had no effect at the end of 3 months after intervention (P0.05), and the scores of FCA in rehabilitation group increased gradually before and after intervention, and there were significant differences between the two groups (P0.05 or 0.01). There was no significant difference in FCA score between the two groups before intervention (P0.05), however, the FCA score of rehabilitation group was significantly higher than that of control group at the end of 3 months and 6 months after intervention (P0.05). The MBI scores in the control group were significantly higher at the end of 6 months than before (P0.05), but had no effect at the end of 3 months after intervention (P0.05), and the scores of MBI in the rehabilitation group increased gradually before and after intervention, and there were significant differences between the two groups (P0.05 or 0.01). There was no significant difference in MBI score between the two groups before intervention (P0.05), but the MBI score of rehabilitation group was significantly higher than that of control group at the end of 3 months and 6 months after intervention (P0.05). There was no significant difference in the scores of physical function, psychological function, social function, material life and overall quality of life between the two groups before intervention (P0.05). The scores of each dimension of GQOL-74 in rehabilitation group were significantly higher than those in control group at the end of 3 and 6 months after intervention (P0.05). Conclusion Community rehabilitation can improve the compliance of patients with cerebral hemorrhage and hemiplegia, promote the recovery of nerve function and improve the quality of life.
【學位授予單位】：南華大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R743.34

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