目的：明确综合康复治疗在单个住院周期中对脑卒中患者日常生活活动（activities of daily living，ADL）能力改善的效果，并探索出院时ADL改善的影响因素。

方法：本研究为回顾性研究，以南京医科大学第一附属医院康复医学中心 2022 年 1 月至 2024年12月收治的320例脑卒中偏瘫患者为研究对象，应用描述性统计分析脑卒中患者 出院时 ADL 改善情况，以巴塞尔指数（Barthel Index，BI）提高>10 分为最小临床重要性差 异（minimal clinically important difference，MCID）进行分组，采用单因素及多因素分析筛 选ADL改善的影响因素。

结果：单个住院周期的综合康复治疗使患者BI平均提高了12.86分，单因素分析显示病程、 入院时 BI 评分、立位平衡、步行能力、认知障碍、情感障碍与 ADL 改善显著相关（P<0.05）； 多 因 素 Logistic 回 归 表 明 ，病 程（OR＝0.996，P＝0.041）、合 并 高 血 压（OR＝0.558， P＝0.050）、入院时步行能力（OR＝0.716，P＝0.000）是ADL改善的独立预测因素。

结论：单个住院周期的综合康复治疗使45.9%的脑卒中患者ADL评分达到具有临床意义的 改善。病程、合并高血压及入院时步行能力可能是影响其ADL改善的主要因素。早期康复 的介入，基础病的预防与管理，以及恰当的康复目标的制定将有助于提升患者的ADL能力， 进一步改善其生活质量。

Objective: To clarify the effect of comprehensive rehabilitation treatment on the improvement of the activities of daily living (ADL) of stroke patients during a single hospitalization period, and to explore the influencing factors of the improvement of ADL at the time of discharge.

Methods: This study was a retrospective study. A total of 320 stroke patients with hemiplegia admitted to the Rehabilitation Medicine Center of The First Affiliated Hospital of Nanjing Medical University, from January 2022 to December 2024 were selected as the research objects. Descriptive statistical analysis was used to analyze the improvement of ADL of stroke patients at the time of discharge. The patients were grouped according to the minimal clinically important difference (MCID), which was defined as an increase of more than 10 points in the Barthel index (BI). Univariate and multivariate analyses were used to screen the influencing factors of ADL improvement.

Results: The comprehensive rehabilitation treatment during a single hospitalization period increased the average BI score of the patients by 12.86 points. Univariate analysis showed that the course of disease, BI score at admission, standing balance, walking ability, cognitive impairment, and emotional disorder were significantly correlated with ADL improvement (P<0.05). Multivariate Logistic regression analysis indicated that the course of disease (OR＝ 0.996, P＝0.041), concurrent hypertension (OR＝0.558, P＝0.050), and walking function (OR＝0.716, P＝0.000) were independent predictive factors for ADL improvement.

Conclusion: Comprehensive rehabilitation therapy during a single hospitalization cycle resulted in clinically significant improvement in ADL in 45.9% of stroke patients. The course of disease, concurrent hypertension, and walking function at admission might be the main factors affecting the improvement of ADL. Early intervention of rehabilitation, prevention and management of underlying diseases, and the formulation of appropriate rehabilitation goals would help improve the patients' ability of ADL and further enhance their quality of life.