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通过对天津市城区脑卒中社区干预地区和对照地区的175名1995～1996年发病的尚存脑卒中患者的预后状况及卫生服务利用情况进行问卷调查分析,结果显示:干预地区、对照地区平均发病年龄分别为64.43岁和62.78岁,干预地区比对照地区推迟1.55岁;后遗症发生率分别为54.9％、78.6％,对照地区明显高于干预地区(P<0.01);平均后遗症数目分别为0.71和1.05,差别有显著性(P<0.01);分别有34.1％和51.2％的患者平时需专人陪伴;1997年1年内,平均陪伴人日数分别为38.2和71.5,差异有显著性(P<0.01);1997年门诊利用次数分别为2.81次和7.58次(P<0.01),差异有显著性;恢复期脑卒中尚存患者1997年复发住院率分别为6.6％、19.0％,差异有显著性(P<0.05)。说明采取干预措施可明显改善脑卒中患者的功能康复,减少后遗症,减少陪伴,降低就医需求。因此应继续加强以高血压防治为重点,以健康教育为主导的综合性社区干预活动的开展并及时把社区干预的成功经验推广到更大范围,推动慢性病社区干预工作的全面展开。
According to the questionnaire survey of the prognosis of 175 surviving stroke patients and the utilization of health services in the intervention areas and control areas of stroke community in urban areas of Tianjin City, the results showed that: the average incidence of intervention areas and control areas With the age of 64.43 years and 62.78 years respectively. The intervention area was 1.55 years later than the control area. The incidence of sequelae was 54.9% and 78.6% respectively. The control area was significantly higher than the intervention area (P <0.01). The average number of sequelae was 0.71 and 1.05 (P <0.01). Patients in 34.1% and 51.2% of patients were accompanied by special carers in general. The average companion days in 1997 were 38.2 and 71.5, respectively, with significant difference (P <0.01). The outpatient visits in 1997 were 2.81 times and 7.58 times respectively (P <0.01), the difference was significant. The recurrent hospitalizations of survivors in recovery period in 1997 were 6.6% and 19.0% respectively, the difference was significant (P < 0.05). This shows that interventions can significantly improve the functional rehabilitation of stroke patients, reduce sequelae, reduce companionship and reduce the need for medical treatment. Therefore, we should continue to intensify the implementation of integrated community intervention focusing on prevention and treatment of hypertension, health education, and popularize the successful experience of community intervention in a larger scope in a timely manner so as to promote the comprehensive intervention of community intervention in chronic diseases.