《国际功能、残疾和健康分类康复组合》在西北戈壁地区膝骨关节炎患者康复中的应用OACSTPCD
Application of the International Classification of Functioning,Disability and Health Rehabilita-tion Set in Rehabilitation of Patients with Knee Osteoarthritis in Northwest Gobi Region
目的 探讨《国际功能、残疾和健康分类康复组合》(ICF-RS)在西北戈壁地区膝骨关节炎(KOA)患者整体功能水平、康复治疗效果和康复疗效与成本效益关系评估中的可行性.方法 选择2022年3月—2023年3月在吉木萨尔县中医医院针灸科住院治疗的KOA患者50例.因患者自身理解偏差、评估依从性不高等原因,中止或脱落8例,最终纳入42例.根据患者功能障碍严重程度,参考《中医康复临床实践指南·膝骨关节炎》制订个性化康复方案,1次/d,6 d/周,共治疗2周.采用ICF-RS评估患者整体功能水平、康复疗效和康复治疗费用.结果 KOA患者主要存在的身体功能障碍依次为b280痛觉、b455运动耐受能力、b130能量和驱力功能、b134睡眠功能;主要存在的活动功能障碍依次为d410改变身体基本姿势、d455到处移动、d415保持一种身体姿势;主要存在的参与功能障碍依次为d850有报酬的就业、d920娱乐与休闲.汉族与少数民族KOA患者ICF-RS各类目(除d240控制应激和其他心理需求外)限定值频数的构成比差异均无统计学意义(P＞0.05).ICF-RS评估结果显示,KOA患者康复治疗后身体功能、活动功能及参与功能3个维度各类目均明显改善(P＜0.001),总体改善率为100%.KOA患者总康复费用为(2 165.44±783.79)元,整体功能总分每改善1分,平均支出康复费用245.09元.结论 ICF-RS可用于评估西北戈壁地区KOA患者的整体功能状况,指导临床康复治疗,还可评价KOA患者康复医疗费用支出.
Objective To explore the feasibility of the International Classification of Functioning,Disability and Health Reha-bilitation Set(ICF-RS)in evaluating the overall functional level,rehabilitation treatment effects,and the relationship between reha-bilitation efficacy and cost-effectiveness of patients with knee osteoarthritis(KOA)in the northwest Gobi region.Methods A total of 50 patients with KOA who were hospitalized in the Acupuncture and Moxibustion Department of Jimsar County Hospital of Tradi-tional Chinese Medicine from March 2022 to March 2023 were selected.A total of eight cases discontinued or dropped out due to comprehension deviation and low assessment compliance,and finally 42 cases were included.Personalized rehabilitation programs were formulated according to the severity of functional disorders referring to the"Clinical Practice Guidelines of Traditional Chi-nese Medicine Rehabilitation for Knee Osteoarthritis".The treatment was conducted once a day,six days a week for two weeks.The ICF-RS was used to evaluate the overall functional level,rehabilitation efficacy and rehabilitation treatment costs.Results The main body functional impairments of patients with KOA were b280 pain sensation,b455 exercise tolerance,b130 energy and drive function,and b134 sleep function in sequence;the main activity limitations were d410 changing basic body postures,d455 moving around,and d415 maintaining a body posture;the main participation dysfunctions were d850 remunerative employment and d920 recreation and leisure.There was no statistically significant difference in the composition ratio of the frequency of the limit values in all categories of ICF-RS(except d240 handling stress and other psychological needs)between Han and ethnic minority patients with KOA(P>0.05).The ICF-RS assessment results showed that,all categories of the body function,activities and participation in patients with KOA increased significantly after treatment(P<0.001),and the overall improvement rate was 100%.The total rehabilitation cost of patients with KOA was(2 165.44±783.79)yuan,with an average rehabilitation expenditure of 245.09 yuan for each one-point improvement in overall functional score.Conclusion The ICF-RS can be used to evaluate the overall functional status of patients with KOA in the northwest Gobi region,guide clinical rehabilitation treatment and evaluate the rehabilitation medical expen-diture for patients with KOA.
姚冬;何毅琪;张琴;刘长花;李泰标;姚才明;王相凤;王钦枫;胡红军
厦门市第五医院,福建 厦门 361101厦门市第五医院,福建 厦门 361101吉木萨尔县中医医院,新疆 吉木萨尔 831700厦门市第五医院,福建 厦门 361101厦门市第五医院,福建 厦门 361101吉木萨尔县中医医院,新疆 吉木萨尔 831700吉木萨尔县中医医院,新疆 吉木萨尔 831700吉木萨尔县中医医院,新疆 吉木萨尔 831700吉木萨尔县中医医院,新疆 吉木萨尔 831700
膝骨关节炎国际功能、残疾和健康分类康复组合身体功能活动功能参与功能西北戈壁地区
knee osteoarthritisInternational Classification of Functioning,Disability and Health Rehabilitation Setbody functionactivity functionparticipation functionnorthwest Gobi region
《康复学报》 2024 (6)
577-583,7
国家自然科学基金面上项目(82272614)
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