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本研究通过成立“三级医院-社区”缺血性脑卒中连续性管理小组,开设脑卒中管理专病门诊,将潍坊社区新发缺血性脑卒中患者纳入管理系统,建立个人情况档案,评估日常生活活动能力,干预卒中复发的相关危险因素,实施包括生活行为方式干预、规范化药物治疗、康复锻炼指导、健康教育、绿色通道快速转诊等管理措施,取得了明显的效果。
In this study, we set up a “tertiary hospital - community” ischemic stroke management team to open stroke management specialist clinic, Weifang community new ischemic stroke patients into the management system, the establishment of personal files , Assess the ability of activities of daily living, interfere with the related risk factors of stroke recurrence, and implement the management measures including intervention of lifestyle behavior, standardization of drug therapy, rehabilitation exercise instruction, health education and quick referral of green channel. Obvious effects have been achieved.