2022 年第 6 期 第 17 卷

缺血性脑卒中患者神经缺损程度与生活质量和自理能力以及社会参与能力的相关性分析

Correlation analysis of neurological impairment degree with quality of life, self-care ability and social participation ability in patients with ischemic stroke

作者：王竹敏杨雪张英李琛琛周卫萍陈铭

英文作者：Wang Zhumin Yang Xue Zhang Ying Li Chenchen Zhou Weiping Chen Ming

单位：上海交通大学医学院附属新华医院神经外科，上海200092

英文单位：Department of Neurosurgery Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai 200092 China

关键词：脑卒中；神经功能；生活质量；自理能力；社会参与

英文关键词：Stroke;Neuralfunction;Qualityoflife;Self-careability;Socialparticipation

• 摘要：

• 目的 探讨缺血性脑卒中患者神经缺损程度与生活质量和自理能力以及社会参与能力的相关性。方法 选择2018年1月至2021年6月上海交通大学医学院附属新华医院348例经临床治疗后出院的缺血性脑卒中患者，分别采用一般情况问卷、临床神经功能缺损评分表（CSS）、生活质量评估量表（SS-QOL）、自我护理能力测定量表（ESCA）、自主参与问卷（IPA）测评患者神经缺损程度、生活质量、自理能力和社会参与能力。依据CSS评分将患者分为轻度缺损组（186例）和中度缺损组（162例），行组间各评分比较，并分析各评分的相关性。结果 348例急性缺血性脑卒中患者CSS评分为（16±4）分。中度缺损组SS-QOL、ESCA各项评分以及总分均低于轻度缺损组，IPA各项评分以及总分均高于轻度缺损组，差异均有统计学意义（P＜0.05或P<0.01）。相关性分析结果显示CSS评分与SS-QOL评分、ESCA评分呈正相关（r=0.454，P<0.001；r=0.341，P=0.002），与IPA评分呈负相关（r=-0.502，P<0.001）。多重线性回归分析结果显示CSS评分、ESCA评分、康复治疗均与缺血性脑卒中患者社会参与能力相关（均P＜0.01）。结论 缺血性脑卒中患者神经缺损程度与生活质量、自理能力以及社会参与能力密切相关，促进神经功能恢复有助于改善患者生活质量、提高其自理能力和社会参与能力。

• Objective To investigate the correlation of neurological impairment degree with quality of life, self-care ability and social participation ability in patients with ischemic stroke. Methods From January 2018 to June 2021, 348 patients with ischemic stroke admitted to Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and discharged after treatment were selected. The general condition questionnaire, clinical neurological impairment rating scale (CSS), quality of life scale(SS-QOL), exercise of self-care agency (ESCA) and impact on participation and autonomy questionnaire(IPA) were used to evaluate the degree of neurological impairment, quality of life, self-care ability and social participation ability of the patients. According to the CSS score, patients were divided into mild defect group (186 cases) and moderate defect group (162 cases). The scores were compared between the groups, and the correlation of the scores was analyzed. Results   The CSS score of all the patients was (16±4). The item-scores and total scores of SS-QOL and ESCA in mild defect group were lower than those in moderate defect group, and the item-scores and total score of IPA in mild defect group were higher than those in moderate defect group(P<0.05 or P<0.01). Correlation analysis showed that CSS score was positively correlated with SS-QOL score and ESCA score（r=0.454, P<0.001; r=0.341, P=0.002）, and negatively correlated with IPA score（r=-0.502, P<0.001）. Multiple linear regression analysis showed that CSS score, ESCA score, and rehabilitation treatment were correlated with social participation ability of patients with ischemic stroke(all P<0.01). Conclusion  The neurological impairment degree in patients with ischemic stroke is closely related to the quality of life, self-care ability and social participation ability. Promoting the recovery of nerve function in patients can improve the self-care ability of patients and the quality of life, and promote the return to society.