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背景专家委员会制定的卒中康复指南应用于退伍军人健康管理部门及国防部卫生保健系统。方法根据以前发表的指南,委员会利用美国预防服务特别工作组制定的标准,评价了截至到2002年发表的文献。指南根据临床随机化实验、非对照性研究等证据提出建议(如缺乏确定的数据则根据专家组的建议)。结果Ⅰ级水平的建议包括:在多学科康复环境中或卒中单元中传递卒中治疗,通过NI HSS对卒中患者进行评价,早期启动康复治疗,对吞咽困难患者进行吞咽功能筛查,积极进行二级预防,预防深静脉血栓等。推荐应用标准化的评价工具制定适合每个患者的全面的治疗计划。强烈建议进行抗抑郁及情感波动方面的治疗。语言治疗师应评价患者的交流及认知障碍,并在需要时提供治疗。患者、家属及护理者是康复小组的重要成员,应当介入康复的全部疗程。这些建议在以下网站可查询:http://stroke.ahajournals.org/cgi/content/full/36/9/e100。并附有每项建议的全文证据表。结论这些建议应平等地应用于所有临床环境中的所有卒中康复患者,而不是仅针对联邦医疗系统的临床问题或资源。
The Stroke Rehabilitation Guide developed by the Background Committee of Experts should be used in Veterans Health Management and Department of Defense health care systems. Methods Based on previously published guidelines, the Committee evaluated the literature published as of 2002 using the criteria developed by the United States Preventive Services Task Force. The guidelines are based on evidence from clinical randomization studies, uncontrolled studies, etc. (If the lack of definitive data is based on expert panel recommendations). Results Level I recommendations include: stroke management in a multidisciplinary rehabilitation or stroke unit, evaluation of stroke patients by NIHSS, early initiation of rehabilitation, swallowing screening of dysphagia patients, active secondary Prevention, prevention and other deep venous thrombosis. It is recommended to use standardized evaluation tools to develop a comprehensive treatment plan for each patient. It is strongly recommended for treatment of depression and mood swings. Speech therapists should evaluate patient communication and cognitive disorders and provide treatment when needed. Patients, family members and caregivers are important members of the rehabilitation team and should be involved in the entire course of rehabilitation. These suggestions are available at http://stroke.ahajournals.org/cgi/content/full/36/9/e100. A full text of each recommendation is attached. Conclusion These recommendations should be applied equally to all stroke rehabilitation patients in all clinical settings, not just the clinical issues or resources of the federal health system.