| 张 娜,周谋望,杨延砚,刘京宇,张元鸣飞,刘小燮.我国三级综合医院康复医学科住院重点病种康复评定开展情况调查[J].中国康复医学杂志,2022,(11):1485~1491 |
| 我国三级综合医院康复医学科住院重点病种康复评定开展情况调查 点此下载全文 |
| 张 娜 周谋望 杨延砚 刘京宇 张元鸣飞 刘小燮 |
| 北京大学第三医院康复医学科，国家康复医学专业医疗质量控制中心，北京市，100191 |
| 基金项目： |
| DOI：10.3969/j.issn.1001-1242.2022.11.008 |
| 摘要点击次数: 886 |
| 全文下载次数: 649 |
| 摘要： |
| 摘要
目的：调查目前我国三级综合医院康复医学科住院重点病种康复评定开展情况，为进一步制定住院重点病种康复评定规范奠定基础。
方法：制定康复医学科住院重点病种康复评定开展情况调查表，通过各省级康复医学质控中心发放至各地有代表性的三级综合医院康复医学科填写，对各省上报数据进行汇总分析。计算每个康复评定方法在全国开展的比例，定义为开展此项康复评定的医院数量占调查医院总数的比例，同时比较全国不同地区（东部、中部和西部）开展比例上的差异。
结果：纳入全国31个省市自治区共计354家三级综合医院，6个住院重点病种相关康复评定开展比例如下：①脑卒中相关评定：Brunnstrom运动功能评定法92.7%、洼田饮水试验84.5%、认知功能障碍筛查81.1%、Fugl-Meyer评定法67.8%、Frenchay构音障碍评估59.9%、西方失语症成套测验（WAB）57.9%、美国国立卫生研究院卒中量表（NIHSS）53.1%、上田敏偏瘫上下肢功能评价39.3%等；②脊髓损伤相关评定：脊髓损伤神经功能评定75.7%、压疮Braden评分70.3%、神经源性膀胱尿流动力学评定43.8%、脊髓损伤后残存自主神经功能评定28.5%等；③脑外伤相关评定：格拉斯哥昏迷量表83.6%、RLA认知功能水平量表41.0%、残疾分级量表28.2%等；④脊柱关节退行性疾病相关评定：JOA腰背痛评分50.3%、Harris髋关节评分47.7%、HSS膝关节评分46.3%、颈椎功能障碍指数37.6%、JOA脊髓型颈椎病评分35.0%、WOMAC骨性关节炎指数评分33.3%等；⑤骨折与运动损伤术后相关评定：HSS膝关节评分52.8%、Harris髋关节评分51.1%、HSS肘关节评定39.0%、WOMAC骨性关节炎指数评分29.4%、膝关节Lysholm评分28.2%；⑥人工关节置换术后相关评定：Harris髋关节评分58.2%、HSS膝关节评分56.8%、膝关节Lysholm评分31.6%；⑦通用康复评定：Bobath三级平衡检查83.1%、改良Barthel指数81.4%、Berg平衡量表78.5%、疼痛评定（VAS/NRS）77.4%、焦虑抑郁自评量表62.1%；步态分析51.1%、6min步行试验45.2%等。全国东中西部地区比较，多项康复评定的开展比例差异显著，差异有显著性意义。
结论：住院重点病种不同康复评定方法开展情况参差不齐，应当加强康复评定的质量控制，制定重点病种相关康复评定规范，组织培训，促进我国康复医疗服务质量的持续提升。 |
| 关键词：康复医学科 康复评定 医疗质量管理 |
| An investigation on rehabilitation assessment of key inpatient diseases in rehabilitation medicine department of tertiary general hospital in China Download Fulltext |
|
| Department of Rehabilitation Medicine， Peking University Third Hospital， Beijing， 100191 |
| Fund Project: |
| Abstract: |
| Abstract
Objective： To investigate the rehabilitation assessment of key inpatient diseases in rehabilitation medicine of China，and lay foundation for further formulating rehabilitation assessment norms.
Method： Formulate the questionnaire on the rehabilitation assessment of key inpatient diseases in rehabilitation medicine department， distribute it to the rehabilitation medicine department of representative tertiary hospitals through the provincial rehabilitation medicine quality control center， then summarize and analyze the data reported， finally the implementation rate of rehabilitation assessment is obtained. At the same time， the differences in the proportion in different regions of the country (eastern， central and western) are compared.
Result： Datas of rehabilitation assessment of key inpatient diseases from 354 tertiary general hospitals were included in the analysis. The rehabilitation assessment of six categories of inpatient key diseases was as follows.①Stroke： Brunnstrom stage 92.7%， water swallow test 84.5%， cognitive impairment screening 81.8%，Fugl-Meyer assessment 67.8%，Frenchay dysarthria assessment 59.9%，Western Aphasia Battery 57.9%， NIHSS 53.1%，etc.②Spinal cord injury： neurological function assessment of spinal cord injury 75.7%， pressure ulcer Braden score 70.3%， neurogenic bladder urodynamics assessment 43.8%， residual autonomic nerve function assessment 28.5%，etc.③Brain trauma： Glasgow Coma Scale83.6%， RLA cognitive function scale 41.0%， Disability rating scale28.2%，etc.④Degenerative diseases of spine and joints： JOA low back pain score 50.3%， Harris hip score 47.7%， HSS knee score 46.3% and cervical spine dysfunction index 37.6%， JOA cervical spondylotic myelopathy score35.0%，WOMAC 33.3%，etc.⑤Postoperation of fracture and sports injury： HSS knee score 52.8%， Harris hip score 51.1%， HSS elbow score 39.0%，WOMAC 29.4%，keen Lysholm score 28.3%.⑥Post-operation of artificial joint replacement： Harris hip score 58.2%， HSS knee score 56.8%， keen Lysholm score31.6%.⑦The general items include Bobath three-level balance test 83.1%， Modified Barthel Index 81.4%， Berg Balance Scale 78.5%， pain assessment(VAS/NRS) 77.4%， Self-rating Anxiety/Depression Scale 62.2%， gait analysis 51.1%，6 Minute Walk Test 45.2%，etc.Among the eastern， central and western regions of China， the proportion of multiple rehabilitation assessments had statistically significant difference.
Conclusion： The development of different rehabilitation assessment for key inpatient diseases was uneven. We should strengthen the quality control of rehabilitation assessment， formulate norms and organize training， so as to realize the continuous improvement of the quality of rehabilitation medical service in China. |
| Keywords:rehabilitation medicine department rehabilitation assessment medical quality management |
|
| 查看全文 查看/发表评论 |
