制定出院计划对脑卒中偏瘫患者出院后疗效观察

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Abstract Objective To explore the efficacy of making discharge plan on stroke patients with hemiplegia after discharge. Methods A total of 60 patients with stroke hemiplegia discharged from the Department of Rehabilitation,Yichun People′s Hospital from April 2019 to March 2020 were selected as the research subjects. They were divided into the control group and the observation group according to the random number table method, with 30 cases in each group. Patients of both groups were given routine oral medication to prevent stroke recurrence, the control group guided the general rehabilitation training after discharge, and the observation group jointly developed a detailed discharge plan by rehabilitation physicians, rehabilitation therapists and nurses, including changing the living environment, simple rehabilitation equipment, specific rehabilitation training methods, etc. The patients were followed up every 2 weeks, and different rehabilitation plans were made according to the functional level. The self-efficacy, neurological deficit score,activity of daily living index, activities of daily living (ADL) index, Fugl-Meyer assessment (FMA) score and quality of life of the two groups were observed at the time of discharge and 3 months after discharge, and the efficacy of upper limb muscle tension, lower limb muscle strength and compliance were evaluated. Results There were no statistically significant difference in the scores of self-efficacy and neurological deficit degree between the two groups at discharge(P＞0.05). Three months after the discharge, the self-efficacy of two groups was higher than that at discharge, while the self-efficacy of the observation group was higher than that of the control group, and the differences were statistically significant (P＜0.05). Three months after the discharge, the neurological deficit degree of two groups was lower than that at discharge, while the neurological deficit degree of the observation group was lower than that of the control group, and the differences were statistically significant (P＜0.05). There were no significant differences in ADL, FMA and quality of life scores between the two groups at discharge (P＞0.05).Three months after the discharge, the ADL, FMA and quality of life scores of two groups were lower than those at discharge, while the ADL, FMA and quality of life scores of the observation group were lower than those of the control group, and the differences were statistically significant (P＜0.05). The efficacy of the upper and lower limb muscle tension of the observation group was higher than that of the control group, and the differences were statistically significant(P＜0.05). The compliance (taking medication on time, controlling tobacco and alcohol control, rehabilitation training,reasonable diet, self-monitoring, re-visit and visit on time) of the observation group was higher than that of the control group, and the difference was statistically significant (P＜0.05). Conclusion The development of discharge plan has a good effect on stroke hemiplegic patients after discharge. It can improve the patients′ self-efficacy, neurological deficit score, activity of daily living index, activity of daily living index, FMA score and quality of life, and improve the upper limb muscle tension efficacy, lower limb muscle strength efficacy and patients′ compliance.

Key words： Making discharge plan Stroke hemiplegia After discharge Curative effect

Received: 17 December 2020

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