Résumé
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 (P<0.05). 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, P<0.05), but the latter cared more about medical quality (F=3.464, P<0.05) and hospitalization length (F=3.692, P<0.05). The patients more than 80 years old cared more about medical qual-ity (F=4.630, P<0.05). The patients selecting continuous treatment in our hospital paid more attention on continuation (F=7.590, P<0.001), while those selecting rehabilitation institutions cared more about rehabilitation capacity (F=32.156, P<0.001), and those selecting communi-ty hospitals or nursing home cared more about hospitalization length (F=18.823, P<0.001), easy to visit (F=14.070, P<0.001), etc. Referral information mainly came from the doctors (72.0%), only 28.0% from the patients. Conclusion Severity of disability, age and the prognosis may impact the choice for the following rehabilitation in acute stroke patients. Doctors can do more for reasonable referral recommendations to the patients.
Résumé
Objective To study the effects of thrombolysis on short-and long-term outcome in acute cerebral infarction patients. Meth-ods The patients accepted thrombolysis and remained severe neurologic deficits were as observation group (n=29), and the patients without thrombolysis matching the onset time and severity of disease were as control group (n=94). They were assessed with National Institute of Health Stroke Scale (NIHSS), Manual Muscle Test (MMT), Brunnstrom Grade, modified Barthel Index (MBI) when they admitted and dis-charged, and with modified Rankin Scale (mRS) 6 months later. Results The scores of MMT, MBI and Brunnstrom grade improved in both groups when discharged (P<0.05), except the NIHSS in the control group, and the scores of NIHSS and MBI improved more in the observa-tion group than in the control group (P<0.05). The score of mRS was better in the observation group than in the control group 6 months later (P<0.05). Conclusion Thrombolysis can improve the neurologic function and activities of daily living in the acute stage of cerebral infarc-tion, as well as the long-term outcome of activities.
Résumé
@#Objective To study the feasibility, safety, tolerance and the effectiveness of constraint-induced movement therapy (CIMT) in early cerebral infarction, and the long-term outcome.Methods 2 weeks after cerebral infarction, 22 patients with upper extremity weakness were divided into treatment group (11 cases, accepted CIMT) and control group (11 cases, accepted routine rehabilitation). They were assessed with Fugl-Meyer Assessment (FMA), Wolf Motor Function Test (WMFT), Motor Activity Log (MAL) and Barthel Index (BI) before and 2 weeks, 3 months after treatment. Results The scores of FMA, WMFT, MAL and BI improved in both group (P<0.05), but more in the treatment group (P<0.05). 3 months after treatment, the score of MAL quality was no different between two group.Conclusion CIMT is safe and effective for early cerebral infarction, and more effective than routine immediately, but it is similar 3 months later.