不同性别出血性脑卒中患者急性期康复效率差异的回顾性研究

Retrospective Study on the Difference of Rehabilitation Efficiency in Acute Stage of Hemorrhagic Stroke Patients of Different Sexes

摘要: 目的：探讨不同性别出血性脑卒中患者在急性期康复效率方面的差异，并分析其影响因素，为制定性别个体化的康复策略提供依据。方法：采用回顾性队列研究设计，选取2024年1月至2025年5月期间收治的92例出血性脑卒中急性期患者作为研究对象，其中男性和女性各46例。收集所有患者的基线资料、临床特征及康复数据。主要评价指标为康复效率系数(计算方法：(入院时NIHSS评分–出院时NIHSS评分)/康复治疗天数)、住院时间及出院时改良Barthel指数(MBI)评分。采用独立样本t检验、χ²检验进行组间比较，并采用多因素Logistic回归分析校正潜在混杂因素。结果：两组患者基线资料无统计学差异(P > 0.05)，具有可比性。男性组的康复效率系数显著高于女性组((0.59 ± 0.21)分/天vs (0.48 ± 0.18)分/天，P < 0.01)，平均住院时间短于女性组((24.36 ± 5.82)天vs (27.15 ± 6.31)天，P < 0.05)，出院时MBI评分高于女性组((68.45 ± 12.37)分vs (62.18 ± 11.95)分，P < 0.05)。多因素Logistic回归分析显示，在调整了年龄、入院神经功能缺损程度、出血量、出血部位等因素后，男性性别是急性期康复效率的独立正向影响因素(OR = 2.34, 95% CI: 1.21~4.52, P = 0.011)。结论：本研究表明，出血性脑卒中患者急性期的康复效率存在显著性别差异，男性患者的康复效率优于女性。性别是康复效果的独立影响因素。临床康复实践中应关注这种差异，考虑制定针对不同性别的个体化康复方案，以优化康复疗效。

Abstract: Objective: To explore the differences in acute rehabilitation efficiency of patients with hemorrhagic stroke between different sexes, and analyze its influencing factors, so as to provide basis for formulating gender-specific rehabilitation strategies. Methods: A retrospective cohort study design was used to select 92 patients with acute hemorrhagic stroke from January 2024 to May 2025, including 46 males and 46 females. Baseline data, clinical features and rehabilitation data of all patients were collected. The main evaluation indexes are rehabilitation efficiency coefficient (calculation method: (NIHSS score at admission-NIHSS score at discharge)/rehabilitation treatment days), hospitalization time and improved Barthel index (MBI) score at discharge. T-test and χ-test of independent samples were used to compare between groups, and multivariate Logistic regression analysis was used to correct potential confounding factors. Results: There was no statistical difference in baseline data between the two groups (P > 0.05), which was comparable. The rehabilitation efficiency coefficient of male group was significantly higher than that of female group ((0.59 ± 0.21) min/day vs (0.48 ± 0.18) min/day, P < 0.01), and the average hospitalization time was shorter than that of female group (24.36 ± 5.82) days vs (27.15 ± 6.31) days, P < 0.05. Multivariate Logistic regression analysis showed that male sex was an independent positive influence factor on rehabilitation efficiency in acute stage after adjusting factors such as age, degree of neurological deficit in hospital, amount of bleeding and location of bleeding (OR = 2.34, 95% CI: 1.21~4.52, P = 0.011). Conclusion: This study shows that there are significant gender differences in the rehabilitation efficiency of patients with hemorrhagic stroke in acute stage, and the rehabilitation efficiency of male patients is better than that of female patients. Gender is an independent influencing factor of rehabilitation effect. In clinical rehabilitation practice, we should pay attention to this difference and consider making individualized rehabilitation programs for different sexes to optimize the rehabilitation effect.