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rt-PA治療効果の医療介護連携に関するプロセス、アウトカム評価指標の開発と検証

rt-PA治疗效果医疗协调相关流程和结果评价指标的制定和验证

基本信息

批准号：
19K10490
负责人：
柿沼倫弘
金额：
$ 2.66万
依托单位：
National Institute of Public Health
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2019
资助国家：
日本
起止时间：
2019-04-01 至 2024-03-31
项目状态：
已结题

项目摘要

今年度は、得られたデータを研究分担者と協力しながら分析、論文執筆を進め英文誌に投稿し、採択された。これは研究計画にほぼ沿うことができたものである。本論文は、t-PAが脳梗塞患者の中期的な機能的自立に与える効果を明らかにすることを目的としたものである。中期的な機能的自立について検証することは、潜在的な患者、患者にとっての退院後の生活を考えるための意識の啓発のみではなく、医療従事者がリハビリテーションの効果、地域の医療提供体制を考えていくうえでも意義がある。t-PAの処方群の患者と非処方群の患者の機能的な予後を比較するために、傾向スコアマッチングを用いて発症時点の患者の状態を年齢、入院時NIHSS、脳梗塞初発、mRSにより調整した。対象の患者は急性期病院を退院し、回復期リハビリテーション病院に転院した同一の患者である。回復期リハビリテーション病院に転院した際と回復期リハビリテーション病院の退院時のFIM（機能的自立度評価表）合計点を比較した。その結果、t-PAの処方群の患者は非処方群よりも回復期病院に転院時のFIMの合計点は有意に高いこと、回復期リハビリテーション病院退院時にはリハビリテーションの効果により差が小さくなるもののt-PA処方群の方がFIMの合計点が高い傾向にあることが判明した。今後は、患者の急性期病院の退院後の経路や要介護度に着目した分析が可能であるのか検討し、先行研究のレビューとともに取り組む予定である。

This year, the participants of this year's research program will participate in the analysis, writing and writing of English papers and articles. The research plan will be completed along the line of study. In this paper, the functional self-reliance of patients with cerebral infarction in the middle stage of t-PA is discussed. In the middle of the year, the ability of self-reliance, potential patients, potential patients, patients, The clinical data of the patients in the t-PA prescription group and the patients in the non-prescription group were compared and compared. The patients' status at the time of admission, NIHSS at the time of admission, infarct onset and mRS after admission were compared and analyzed. In the acute stage, the patients were discharged from the hospital, and during the return period, the patients in the hospital were discharged from the hospital. During the return period, the FIM (functional independence scale) was calculated and compared during the return period. The results showed that the patients in the t-PA group had the intention to have high levels of hospitalization when they were not in the hospital during the recovery period, and those who were in the hospital during the recovery period had the intention to do so. The results showed that there was a significant difference between the two groups when they were discharged from the hospital. the results showed that there was a significant difference between the two groups. The square group of t-PA patients showed that the FIM of the square group of patients in the non-prescription group was significantly higher than that of the FIM group during the hospital exit period. In the future, after the patient is discharged from the acute stage of the hospital, it is important to focus on the analysis of the possibility that he or she may be affected, and we should first study how to determine the number of patients.