Effect of intermediate care on the recurrence and recurrence rate of elderly patients with cerebral infarction / 中国综合临床

ABSTRACT

Objective To observe the effect of intermediate care on recurrence factors and recurrence rate of elderly patients with cerebral infarction.Methods Five Hundred and ninety-eight cases of acute cerebral stroke were divided into two groups,301 cases in the experimental group and 297 cases in the control group.After the acute stage,patients in the experimental group was included into the intermediate care unit.The experimental group was given comprehensive evaluation and multidisciplinary management,including the combination of traditional Chinese and Western medicine treatment,rehabilitation training and physical therapy,medication guidance,nursing and health education.After the acute stage of the disease,the control group patients were in the general ward.The course of treatment was 2 weeks.At baseline(t0),second weeks(t1),sixth months(t2)and twelfth months(t3),the blood pressure(SBP,DBP),fasting blood-glucose(FBG),blood lipid(TC,TG,LDL),serum homocysteine(Hcy)level and the recurrence rate of cerebral infarction in all two groups were observed.Results SBP at t1,t2 and t3 was lower than that at t0 in the experimental group,and the difference was statistically significant(P＜0.05).SBP in the experimental group at t2 and t3 was lower than that in the control group.There was significant difference between the experimental group and the control group(P＜0.05).DBP at t2 and t3 was lower than that at t0 in the experimental group,and the difference was statistically significant(P＜0.05).DP in the experimental group at t2 and t3 was lower than that in the control group.There was significant difference between the experimental group and the control group(P＜0.05).FBG at t1((5.34±0.76)mmol/L),t2(5.86±1.05)mmol/L)and t3(5.62±0.89)mmol/L)were lower than that at t0((7.27±2.34)mmol/L),and the difference was statistically significant(P＜0.05).FBG in the experimental group at t2 and t3 were lower than that in the control group((6.85±0.92)mmol/L,(6.36±1.03)mmol/L).There was significant difference between two groups(P＜0.05).TC at t1((4.86±0.85)mmol/L),t2((4.21±0.76)mmol/L)and t3((3.95±0.64)mmol/L)were lower than that at t0((5.56±1.06)mmol/L),and the difference was statistically significant(P＜0.05).TC in the experimental group at t2 and t3 was lower than that in the control group((5.06±0.93)mmol/L,(4.84±0.76)mmol/L).There was significant difference between two groups(P＜0.05).TG at t3((1.48±0.26)mmol/L)was lower than that at t0((1.86±1.31)mmol/L),and the difference was statistically significant(P＜0.05).TG in the experimental group at t3 was lower than that in the control group((1.71±0.66)mmol/L).There was significant difference between two groups(P＜0.05).LDL at t1((3.76±0.92)mmol/L),t2((3.09±0.62)mmol/L)and t3((2.59±0.51)mmol/L)were lower than that at t0((4.59±1.45)mmol/L),and the difference was statistically significant(P＜0.05).LDL in the experimental group at t2and t3 was lower than that in the control group((4.09±0.75)mmol/L,(4.12±0.64)mmol/L).There was significant difference between two groups(P＜0.05).Hcy at t1((14.16±3.17)μmol/L),t2((10.37±2.59)μmol/L)and t3((10.10±1.86)μmol/L)were lower than that at t0((23.62±5.62)μmol/L),and the difference was statistically significant(P＜0.05).Hcy in the experimental group at t2and t3 was lower than that in the control group((18.52±3.64)μmol/L,(16.37±2.75)μmol/L).There was significant difference between two groups(P＜0.05).The recurrence rate of cerebral infarction within 1 years was 4.7％(14/301)and 7.1％(21/297)in the experimental group and the control group.There was a decreasing tendency,but no statistical significance(P=0.208).Conclusion The intermediate care may affect the blood pressure,FBG,blood lipids,serum Hcy levels in elderly patients with cerebral infarction,so as to reduce the recurrence rate of cerebral infarction.