急性脑卒中患者出院后去向及转诊的影响因素-中国康复理论与实践.PDFVIP

中国康复理论与实践2017年1月第23卷第1期 ChinJRehabilTheoryPract,Jan., 2017,Vol.23,No.1 - 106 - DOI: 10.3969/j.issn. 1006-9771.2017.01.025 ·临床研究 · 急性脑卒中患者出院后去向及转诊的影响因素① 屠建莹，任筱舒，陆博逊 [摘要] 目的 研究脑卒中患者在综合医院完成急性期治疗后，后续康复机构选择及相关影响因素。方法 回顾2015 年1月至 12月急性期脑卒中患者230 例，探讨年龄、首次出院时改良Rankin 量表(mRS)评分、转诊机构选择等因素对转诊选择的影响。结 果 共125例有转诊需求。mRS 恶化，转诊需求增高(P0.05) 。在转诊患者中，mRS 0~ 1分及2~3 分患者对延续康复的需求高(F= 4.300, P0.05) ；mRS 4~5 分组对医疗质量(F=3.464, P0.05)和对住院时长要求高(F=3.692, P0.05) 。≥80 岁组对医疗质量要求更高 (F=4.630, P0.05) 。在本院继续治疗者更关注延续康复治疗(F=7.590, P0.001) ，选择康复专科机构者更关注康复质量(F=32.156, P 0.001) ，选择社区和养老机构者则更多考虑住院时长(F= 18.823, P0.001)和方便照料(F= 14.070, P0.001)等。转诊医疗机构的信息来 源于医生占72.0% ，来源于患者占28.0% 。结论 脑卒中急性期患者的功能障碍程度、年龄、对最终预后的预期影响对转诊的选 择。医方掌握更多的康复医疗资源，在转诊过程中可给患方提供更为合理的建议。 [关键词] 脑卒中；康复；转诊；影响因素 Factors Impacting Whereabouts and Referral in Patients with Acute Stroke after Discharge TU Jian-ying, REN Xiao-shu, LU Bo-xun Department of Neurology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China Correspondence to TU Jian-ying. E-mail: tujyy@ Abstract: Objective To study the selection of the follow-up care and related factors in stroke patients after acute treatment in general hospital. Methods A total of 230 acute stroke patients discharged from January to December, 2015, were reviewed. They were classified with age, modified Rankin Scale (mRS) score, referral options, etc., and the key consideration in the selection were compared. Results There were 125 patients needing referral. Referral increased while mRS worsening (P0.05). The demand for the continuation of rehabilita- tion was higher in the patients with mRS scores of 0- 1 and 2-3 than that of 4-5 (F=4.300, P0.05), but the latter cared more about medical quality (F=3.464, P0.05) and hospitali