摘要
目的分析改良版约翰霍普金斯认知量表(Johns-Hopkins cognitive exam,ACE)在评估脑出血重症患者结束身体约束中的作用。方法选取2017年3月-2017年9月在绍兴市中心医院诊断且符合纳入标准的91例脑出血重症患者为研究对象,依据ACE评分结果将其分为定向力正常组(38例)和定向力非正常组(53例),定向力正常组患者解除约束,定向力非正常组继续予以约束,比较2组患者的非计划拔管发生率、认知功能评分,分析定向力与认知总分的相关性。结果定向力正常组患者非计划拔管发生率(0.00%)明显低于定向力非正常组非计划拔管发生率(16.98%),差异有统计学意义(P<0.05);定向力正常组患者的模仿能力、语言能力、注意力与计算力、记忆力及认知总分均明显高于定向力非正常组,差异有统计学意义(均P<0.05);Spearman分析结果显示,患者定向力与其认知总分呈正相关(r=0.839,P<0.001)。结论 ACE可通过评定患者定向力,评价患者认知功能,进而为脑出血重症患者解除身体约束提供参考。
Objective To analyze the role of adapted Johns-Hopkins cognitive exam(ACE) in assessing the end of physical restraint in severe patients with cerebral hemorrhage. Methods A total of 91 severe patients with cerebral hemorrhage diagnosed in our hospital were selected from March 2017 to September 2017, who were divided into directional force normal group(38 cases) and directional force abnormal group(53 cases). The normal group was released from restraint, and the abnormal group was continued to be restrained. The incidence of unplanned extubation and cognitive function score were compared between the two groups, and the correlation between orientation and cognition score were analyzed. Results The incidence of unplanned extubation in directional force normal group(0.00%) was significantly lower than that in directional force abnormal group(16.98%, P<0.05). The score of imitation ability, language competence, attention and calculation, memory and cognition in normal group was significantly higher than the abnormal group(all P<0.05). The results of Spearman analysis showed that the patient’s directional power was positive correlated with the total score of cognition(r=0.839, P<0.001). Conclusion ACE can provide reference for severe cerebral hemorrhage patients to relieve physical restraint by evaluating cognitive function and directional ability.
作者
陶琴琴
卢锦竹
徐孙燕
张露
陈茜
何萍
TAO Qin-qin;LU Jin-zhu;XU Sun-yan;ZHANG Lu;CHEN Qian;HE Ping(Department of Neurosurgery,Shaoxing Central Hospital,Shaoxing,Zhejiang 312030,China)
出处
《中华全科医学》
2020年第2期236-238,共3页
Chinese Journal of General Practice
基金
2016年浙江省医药卫生科技项目(2016KYB126)。
关键词
改良版约翰霍普金斯认知量表
脑出血
重症患者
身体约束
Adapted Johns-Hopkins cognitive exam
Cerebral hemorrhage
Severe patients
Physical restraint
