摘要
目的:观察卒中单元护理对缺血性脑卒中患者预后的影响。方法:选择哈尔滨医科大学附属第一医院收治的缺血性脑卒中患者216例,采用随机数字表法分为对照组和观察组,每组108例。对照组在对症治疗基础上,给予健康教育、心理疏导、早期肢体康复训练等常规神经内科康复护理,干预1个月;观察组给予卒中单元模式护理,干预1个月,入院后成立专业的卒中单元护理小组,科学制定个体化康复方案,包括:①科学评估患者情况,给予相应营养支持;②待患者病情稳定,有针对性开展健康教育,如脑卒中知识讲座、指导预防摔倒和误吸等;③有针对性开展心理疏导;④根据患者情况个性化制定肢体康复、吞咽功能康复、呼吸功能康复训练及中医理疗,并加强出院随访。分别于干预前及干预1个月后,检测血清内脂素、脂联素、甘油三脂、总胆固醇水平,采用美国国立卫生研究院卒中量表(NIHSS)评分评估神经功能缺损,Fugl-Meyer运动功能评定法(FMA)评估肢体运动功能,改良Barthel指数(MBI)评定日常生活能力,汉密顿抑郁量表(HAMD)评估患者抑郁状态,并记录患者临床转归、并发症发生率及患者对护理满意度。结果:干预前,2组内脂素、脂联素、甘油三脂、总胆固醇水平、NIHSS、FMA、HAMD、MBI评分均无明显差别,差异无统计学意义(P>0.05);与干预前比较,2组干预1个月后的内脂素、甘油三脂、总胆固醇水平、NIHSS、HAMD评分均明显降低,脂联素水平、FMA、MBI评分均明显升高,差异均有统计学意义(P<0.05);与对照组比较,观察组干预1个后内脂素、甘油三脂、总胆固醇水平、NIHSS、HAMD评分均更低,脂联素水平、FMA、MBI评分均更高,差异均有统计学意义(P<0.05);观察组患者预后优良率(94.44%)、患者护理满意度(98.15%)均高于对照组(75.00%、80.56%),并发症发生率(7.41%)低于对照组(38.89%),差异有统计学意义(P<0.05)。�
Objective:To observe the effect of stroke unit nursing on the prognosis of patients with ischemic stroke.Methods:A total of 216 patients with ischemic stroke which were treated in the first affiliated hospital of Harbin Medical University were randomly divided to the control group and observation group,with 108 patients in each group.The control group was given neurology department symptomatic treatment and routine neurological rehabilitation nursing,such as health education,psychological guidance,early limb rehabilitation training,etc.the continuous intervention was for one month.The observation group was given stroke unit nursing mode,continuous intervention for one month.After admission,a professional stroke unit nursing team was established to scientifically formulate individual rehabilitation programs,including the following aspects:①To evaluate the patients’condition scientifically and provide corresponding nutrition support.②To carry out health education when the patients’condition is stable,such as lectures on stroke knowledge,guidance on the prevention of falls and aspiration,and so on.③To carry out targeted psychological counseling.④To carry out personalized rehabilitation programs such as limb rehabilitation,swallowing rehabilitation,respiratory rehabilitation training and traditional Chinese medicine physical therapy,and strengthen discharge follow-up.Serum visfatin,adiponectin,triglyceride and total cholesterol levels were measured before intervention and one month after intervention.NIH stroke scale(NIHSS)was used to evaluate neurological deficit,Fugl-Meyer assessment(FML)was used to assess limb motor function,modified Barthel index(MBI)was used to assess daily living ability,Hamilton depression scale(HAMD)was used to assess depression status,and clinical outcomes,complication rates and patient satisfaction with care were recorded.Results:Before intervention,there was no significant difference in the levels of visfatin,adiponectin,triglyceride,total cholesterol and the scores of NIHSS,FM
作者
张立敏
逄冬
ZHANG Limin;PANG Dong(The First Affiliated Hospital of Harbin Medical University,Harbin,Heilongjiang 150000,China;The Second Affiliated Hospital of Harbin Medical University,Harbin,Heilongjiang 150001,China)
出处
《康复学报》
CSCD
2020年第2期119-123,144,共6页
Rehabilitation Medicine
基金
国家“十二五”科技攻关项目(2011BAI11B01)。
关键词
缺血性脑卒中
卒中单元护理
康复
运动功能
神经功能
ischemic stroke
stroke unit nursing
rehabilitation
motor function
nerve function
