脑卒中数字疗法：从筛查到干预的进展与挑战

doi:10.12114/j.issn.1007-9572.2025.0147

中国全科医学 ›› 2026, Vol. 29 ›› Issue (02): 240-246.DOI: 10.12114/j.issn.1007-9572.2025.0147

所属专题：数智医疗最新文章合辑；神经/行为/心理最新文章合辑

脑卒中数字疗法：从筛查到干预的进展与挑战

余浩, 廖鹏, 罗力^*()

200032　上海市，复旦大学公共卫生学院

收稿日期:2025-07-10 修回日期:2025-09-15 出版日期:2026-01-15 发布日期:2025-12-11
通讯作者: 罗力
作者贡献：
余浩负责文章的构思与设计、研究资料的收集与整理、论文撰写，表格的编辑、整理；廖鹏负责论文修订；罗力负责文章的质量控制及审校、对文章整体负责，监督管理。
基金资助:
上海市加强公共卫生体系建设三年行动计划（2023-2025年）重点学科建设项目(GWVI-11.1-44)

Digital Therapy for Stroke: Progress and Challenges from Screening to Intervention

YU Hao, LIAO Peng, LUO Li^*()

School of Public Health, Fudan University, Shanghai 200032, China

Received:2025-07-10 Revised:2025-09-15 Published:2026-01-15 Online:2025-12-11
Contact: LUO Li

摘要/Abstract

摘要： 脑卒中是我国居民死亡和残疾的主要原因之一，给患者和社会带来沉重负担。数字疗法作为一种新兴治疗手段，在脑卒中全病程管理中展现出巨大潜力。本文综述了数字疗法在脑卒中筛查、预防、急性期管理、康复和长期随访等方面的研究进展，分析了数字疗法临床应用的优势和面临的挑战，并对未来发展方向进行展望。当前研究显示，数字疗法可显著提高脑卒中风险筛查的覆盖率和准确性，在康复训练中可提供个性化、高强度的干预方案，并通过远程监测改善患者长期管理效果。然而，数字疗法在标准化评估体系、循证医学证据、老年患者适应性、数据安全和医保政策等方面仍面临诸多挑战。未来需加强高质量临床研究，完善标准化评价体系，推动多学科协作，并制定合理的医保政策，促进数字疗法在脑卒中防治中的规范应用与发展。

关键词: 脑卒中, 数字疗法, 筛查, 干预, 康复, 循证医学

Abstract:

Stroke is one of the main causes of death and disability among residents in China, which imposes a heavy burden on patients and society. Digital therapy, as an emerging treatment method, has shown great potential in the management of the entire stroke course. This article reviewed the research progress of digital therapy in stroke screening, prevention, acute phase management, rehabilitation, and long-term follow-up. It analyzed the advantages and challenges of clinical application of digital therapy and looked forward to future development directions. Current research showed that digital therapy could significantly improve the coverage and accuracy of stroke risk screening, provided personalized and high-intensity intervention plans in rehabilitation training, and improved long-term patient management outcomes through remote monitoring. However, digital therapy still faces many challenges in standardized evaluation systems, evidence-based medicine, elderly patient adaptability, data security, and medical insurance policies. In the future, it is necessary to strengthen high-quality clinical research, improve standardized evaluation systems, promote interdisciplinary collaboration, and formulate reasonable medical insurance policies to promote the standardized application and development of digital therapies in stroke prevention and treatment.

Key words: Stroke, Digital therapy, Screening, Intervention, Rehabilitation, Evidence-based medicine

余浩,廖鹏,罗力. 脑卒中数字疗法：从筛查到干预的进展与挑战[J]. 中国全科医学, 2026, 29(02): 240-246. DOI: 10.12114/j.issn.1007-9572.2025.0147.
YU Hao,LIAO Peng,LUO Li. Digital Therapy for Stroke: Progress and Challenges from Screening to Intervention[J]. Chinese General Practice, 2026, 29(02): 240-246. DOI: 10.12114/j.issn.1007-9572.2025.0147.

图/表 5

参考文献 41

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数字工具类型	样本量（名）	灵敏度（%）	特异度（%）	阳性预测值（%）
心电手表^[13]	419 297	92.6	98.2	84.0
PPG手环^[15]	8 635	91.2	94.8	78.5
单导联心电记录仪^[16]	5 214	96.2	94.0	76.4
智能手机App^[17]	2 100	84.9	91.5	64.8

数字工具类型	样本量（名）	灵敏度（%）	特异度（%）	阳性预测值（%）
心电手表^[13]	419 297	92.6	98.2	84.0
PPG手环^[15]	8 635	91.2	94.8	78.5
单导联心电记录仪^[16]	5 214	96.2	94.0	76.4
智能手机App^[17]	2 100	84.9	91.5	64.8

干预类型	样本量（名）	干预时长（月）	主要结局指标	干预效果
移动健康管理平台^[18]	2 876	24	脑卒中发生率	降低28.6%
游戏化行为干预^[21]	1 234	6	健康行为改变	步行量增加1 850步/d
远程监测预警系统^[24]	1 876	12	风险事件预警	准确率82.6%
综合干预平台^[20]	2 105	18	脑卒中复发率	降低17.5%

干预类型	样本量（名）	干预时长（月）	主要结局指标	干预效果
移动健康管理平台^[18]	2 876	24	脑卒中发生率	降低28.6%
游戏化行为干预^[21]	1 234	6	健康行为改变	步行量增加1 850步/d
远程监测预警系统^[24]	1 876	12	风险事件预警	准确率82.6%
综合干预平台^[20]	2 105	18	脑卒中复发率	降低17.5%

技术类型	主要功能	适用阶段	适用功能障碍	优势	局限性
VR康复系统	沉浸式训练	恢复期/缓慢恢复期	运动功能/认知功能	高参与度、可量化	设备成本高、适应性要求高
AR康复系统	视觉引导和反馈	恢复期	步态/平衡功能	实时反馈、易于接受	技术要求高、场地限制
远程康复系统	居家监督训练	恢复期/缓慢恢复期	综合功能障碍	便利、长期坚持	缺乏直接指导、技术依赖性
AI个性化系统	动态调整方案	全康复阶段	多种功能障碍	精准化、效率高	算法复杂、需大数据支持
机器人辅助系统	高强度精准训练	急性期/恢复期	肢体运动功能	高强度、精准	成本极高、操作复杂

脑卒中数字疗法：从筛查到干预的进展与挑战

Digital Therapy for Stroke: Progress and Challenges from Screening to Intervention

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