内科

目的了解老年缺血性卒中共病患者的失能情况，并分析其影响因素。方法采用便利抽样法，选取2022年10月至2023年4月在深圳市第二人民医院神经内科住院治疗的164例老年缺血性卒中共病患者作为研究对象。收集患者的临床资料，采用Barthel指数评估患者的失能情况。通过单因素分析初步筛选变量，采用二元logistic回归模型进一步分析老年缺血性卒中共病患者失能的独立影响因素。结果 164例老年缺血性卒中共病患者中，84例出现失能，发生率为51.22%。单因素分析结果显示，失能组（n=84，Barthel指数≤95分）和非失能组（n=80，Barthel指数>95分）在住院天数、年龄、共病情况、营养风险、认知障碍、美国国立卫生研究院卒中量表（NIHSS）评分方面差异均有统计学意义（均P<0.05）。二元logistic回归分析结果显示，住院天数（OR=2.445，95%CI：1.117～5.352）、营养风险（OR=2.801，95%CI：1.037～7.567）、认知障碍（OR=4.462，95%CI：1.476～13.493）、NIHSS评分（OR=1.945，95%CI：1.413～2.676）均是老年缺血性卒中共病患者失能的独立影响因素（均P<0.05）。结论老年缺血性卒中共病患者失能发生率较高，住院天数、营养风险、认知障碍、NIHSS评分是该群体失能的独立影响因素。医务人员应有针对性地采取护理措施及治疗方案，防止或延缓老年缺血性卒中共病患者发生失能。

Objective To investigate the disability in elderly ischemic stroke patients with comorbidities and to analyze its influencing factors. Methods By convenience sampling, 164 elderly ischemic stroke patients with comorbidities who were hospitalized in the Department of Neurology of Shenzhen Second People's Hospital from October 2022 to April 2023 were selected as the study subjects. Patients' clinical data were collected, and the Barthel index was used for their disability evaluation. Univariate analysis was used to screen the variables preliminarily, and the binary logistic regression model was used to further analyze the independent influencing factors for disability in elderly ischemic stroke patients with comorbidities. Results Among the 164 elderly ischemic stroke patients with comorbidities, 84 were disabled, with an incidence of 51.22%. Results of the univariate analysis showed that there were statistically significant differences in the number of days of hospitalization, age, comorbidities, nutritional risk, cognitive impairment, and National Institutes of Health Stroke Scale (NIHSS) score between the disabled group (n=84, Barthel index ≤95) and the non-disabled group (n=80, Barthel index >95) (all P<0.05). Results of the binary logistic regression analysis showed that the number of days of hospitalization (OR=2.445, 95%CI: 1.117-5.352), nutritional risk (OR=2.801, 95%CI: 1.037-7.567), cognitive impairment (OR=4.462, 95%CI: 1.476-13.493), and NIHSS score (OR=1.945, 95% CI: 1.413-2.676) were independent influencing factors for disability in elderly ischemic stroke patients with comorbidities (all P<0.05). Conclusion The incidence of disability is quite high in elderly ischemic stroke patients with comorbidities, and the number of days of hospitalization, nutritional risk, cognitive impairment, and NIHSS score are independent influencing factors for disability in this group. Medical personnel should take targeted nursing measures and treatment regimens to prevent or delay the development of disability in elderly ischemic stroke patients with comorbidities.