关键词: 康复; 三级康复网络; 功能障碍; 康复护理

Abstract: Stroke is characterized by high morbidity, high mortality and high disability. Rehabilitation for stroke patients can improve dysfunctions and activities of daily living (ADL), and potentially prevent stroke-related complications. Therefore, surviving patients could return to their families and fit into the world. Standardized rehabilitation procedures and programs are particularly critical. This guideline will introduce the stroke rehabilitation management model, the tertiary stroke rehabilitation network. Recommendations were formed on the assessment and rehabilitation of specific functional disorders (motor dysfunction, sensory impairment, dysphagia, dysarthria, aphasia, cognitive disorder, cardiopulmonary dysfunction, psychological disorder), rehabilitation of ADL and social participation disorders, vocational rehabilitation, assessment and rehabilitation of complications (skin breakage, contracture, deep vein thrombosis, intestinal and bladder incontinence, hemiplegic shoulder pain, shoulder-hand syndrome, central pain, osteoporosis), and rehabilitation nursing. 

Key words: Rehabilitation; Tertiary stroke rehabilitation network; Dysfunction; Rehabilitation nursing