广西医学

目的　构建基于脑卒中恢复期跌倒风险分级的中西医结合康复方案并评价其应用效果。方法　选取62例脑卒中恢复期患者作为研究对象，将其分为对照组（n=30）和干预组（n=32）。通过文献检索、专家访谈构建基于脑卒中恢复期跌倒风险分级的中西医结合康复方案。对照组实施脑卒中常规康复护理；干预组依据跌倒风险等级（低、中、高风险）实施中西医结合康复方案，以及协同护理模式下健康教育。比较两组患者干预前后的修订版跌倒效能量表（MFES）评分、Berg平衡量表（BBS）评分、Fugl⁃Meyer评定（FMA）量表评分、脑卒中跌倒知识知晓度量表评分，以及住院期间跌倒发生率。结果　（1）干预4周后，干预组的室外日常活动维度得分及MFES总分高于对照组（P<0.05）；干预6周后，干预组的室内日常活动维度得分、室外日常活动维度得分及MFES总分高于对照组（P<0.05）；两组患者的室内日常活动维度得分、MFES总分及干预组室外日常活动维度得分随干预时间增加而逐渐升高（P<0.05）。（2）干预组的BBS评分随干预时间的增加而逐渐升高，且干预4周后及干预6周后，干预组的BBS评分高于对照组（P<0.05）。（3）干预6周后，干预组上肢FMA量表评分及下肢FMA量表评分均高于干预前及对照组（P<0.05）。（4）干预后，干预组患者及其照顾者脑卒中恢复期跌倒知识知晓度量表评分高于干预前及对照组（P<0.05）。（5）干预组在院期间跌倒发生率低于对照组（P<0.05）。结论　实施基于脑卒中恢复期跌倒风险分级的中西医结合康复方案，能显著提升患者跌倒自我效能水平、平衡功能、运动功能，以及患者及其照顾者的脑卒中恢复期跌倒知识知晓度，降低脑卒中恢复期跌倒发生率。

Objective To construct a rehabilitation regimen of integrated Traditional Chinese and Western Medicine based on fall risk classification of patients in stroke recovery period, and to evaluate its application effect. Methods A total of 62 patients in stroke recovery period were selected as the research subjects, and they were divided into control group (30 cases) or intervention group (32 cases). Through literature search and expert interviews, a rehabilitation regimen of integrated Traditional Chinese and Western Medicine based on fall risk classification in stroke recovery period was constructed. The control group was given routine stroke rehabilitation and nursing, whereas the intervention group received integrated Traditional Chinese and Western Medicine rehabilitation regimen according to the fall risk classification (low, medium and high risk), and health education was carried out under the collaborative nursing mode. The Modified Falls Efficacy Scale (MFES) score, Berg Balance Scale (BBS) score, Fugl⁃Meyer Assessment (FMA) scale score, fall knowledge awareness scale score of cerebral stroke, and the incidence rate of falls during hospital stay were compared between the two groups before and after intervention. Results (1) After 4 weeks of intervention, the intervention group exhibited higher scores in dimension of outdoor daily activities and of total MFES compared to the control group (P<0.05). After 6 weeks of intervention, compared with the control group, the intervention group yielded higher scores in dimensions of in⁃ and outdoor daily activities, as well as higher total score of MFES (P<0.05). Scores in dimension of indoor daily activities and of total MFES in both groups, as well as scores in dimension of outdoor daily activities in the intervention group revealed an upward trend with the prolonging of intervention time (P<0.05). (2) BBS score of the intervention group elevated with the prolonging of intervention time, whereas the intervention group interpreted a higher score compared to the control group after 4 and 6 weeks of intervention (P<0.05). (3) After 6 weeks of intervention, upper⁃ and lower⁃extremity FMA scale scores in the intervention group were higher than those before intervention and the control group (P<0.05). (4) Fall knowledge awareness scale score in stroke recovery period of patients and their caregivers in the intervention group was higher after intervention compared with before intervention and the control group (P<0.05). (5) The intervention group depicted a lower incidence rate of falls during hospital stay as compared with the control group (P<0.05). Conclusion Implementing integrated Traditional Chinese and Western Medicine rehabilitation regimen based on fall risk classification can prominently improve fall self⁃efficacy level, balance function, motor function of patients in stroke recovery period, as well as improve fall knowledge awareness in stroke recovery period of patients and their caregivers, and reduce the incidence rate of falls in stroke recovery period.

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