住院脑卒中患者卧床常见并发症与出院后生活质量的相关性研究

目的 探讨住院脑卒中患者卧床常见并发症（压力性损伤、下肢深静脉血栓形成、肺部感染、泌尿系统感染）与出院后生活质量的相关性,为制订相应的干预措施提供依据。 方法 采用便利抽样的方法,选取全国6省市25所医院3 238例脑卒中卧床患者,使用病例报告表获取患者住院期间并发症发生情况,患者出院后进行电话随访,使用欧洲五维度健康量表测量患者生活质量。 结果 住院期间,626例（19.33%）患者至少发生过1种常见并发症,包括压力性损伤（80例,2.47%）、下肢深静脉血栓形成（29例,0.90%）、肺部感染（500例,15.44%）和泌尿系统感染（91例,2.81%）。发生并发症的患者欧洲五维度健康量表健康描述系统各维度（行动能力、自我照护能力、日常活动能力、疼痛或不舒服、焦虑或抑郁）报告问题的比例高于未发生并发症的患者,且视觉模拟评分低于未发生并发症的患者。 结论 积极预防卧床常见并发症有助于提升脑卒中患者的生活质量,降低疾病负担。

The correlation between complications of bed rest and quality of life after discharge among hospitalized stroke patients

Objective To describe the correlation between common complications of bed rest（pressure ulcer,deep vein thrombosis,pulmonary infection,and urinary tract infection） during hospitalization and the health-related quality of life after discharge among bedridden patients with stroke,in order to provide reference to form specific strategies. Methods A total of 3 238 stroke patients from 25 hospitals in 6 provinces or cities were recruited by convenience sampling. Common complications of bed rest during hospitalization were measured by case report form,and quality of life after discharge was measured using the EQ-5D scale by telephone interview. Results Among the 3 238 bedridden stroke patients,626（19.33%） patients experienced at least one of the major complications,including pressure ulcer（80,2.47%）,deep vein thrombosis（29,0.9%）,pulmonary infection（500,15.44%）,and urinary tract infection（91,2.81%）. Patients with any of the four complications during hospitalization reported more problems in all EQ-5D dimensions（Mobility,Self-Care,Usual Activities,Pain/Discomfort,and Anxiety/Depression） and had lower mean EQ-VAS scores than those without any complications. The occurrence of any complication was significantly associated with the proportion of reported problems in all dimensions after adjustment for confounding variables. Conclusion Common complications of bed rest were significantly associated with quality of life among stroke patients. Prevention of complications is vital to improve quality of life and reduce burden of disease for stroke patients.