对中风治疗的替代策略:一个前性随机对照试验
1Department of Medicine, Guy's, King's and St Thomas's School of Medicine, London, UK. lalit.kalra@kcl.ac.uk
Lancet (London, England)
|October 19, 2000
概括
与中风小组或家庭护理相比,专业中风小组显著降低了死亡率和制度化. 这种有组织的护理改善了患者的治疗结果,并减少了中风后的长期依赖.
科学领域:
- 神经学 神经学
- 公共卫生 公共卫生
- 医疗保健管理的管理
背景情况:
- 组织专业的中风护理改善了患者的治疗结果.
- 不同的中风护理组织模式的比较有效性仍然不清楚.
- 这项研究评估了中风单位与中风团队和家庭护理.
研究的目的:
- 为了比较中风小组护理与中风小组支持和家庭中风护理的疗效.
- 确定急性中风患者管理的最佳组织模式.
- 评估护理组织对患者死亡率,制度化和功能独立性的影响.
主要方法:
- 一个单盲,随机对照试验,涉及457名急性中风患者.
- 患者被分配到中风病房,一般病房,支持中风小组,或在发作后72小时内在家接受中风护理.
- 结果,包括死亡或住院,在3,6和12个月后使用治疗意图分析进行评估.
主要成果:
- 与中风小组 (14%对30%) 和家庭护理 (14%对24%) 相比,中风病组护理导致1年后死亡率或住院率明显降低.
- 与中风小组 (66%) 或家庭护理 (71%) 相比,接受中风小组护理的患者在1年内活着并且没有严重残疾的比例更高 (85%).
- 这些好处在中风后的3个月和6个月内一直观察到.
结论:
- 脑卒中单位在降低中风后的死亡率,制度化和长期依赖方面表现出卓越的有效性.
- 专业中风病房提供更好的结果比一般病房中风队支持或家庭护理.
- 这些发现支持专门用于急性中风管理的中风单位的实施.
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