康复护理联合依达拉奉干预脑梗后遗症期神经功能缺损随机平行对照研究
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摘要
[目的]观察康复护理联合依达拉奉干预脑梗后遗症期神经功能缺损效果。[方法]使用随机平行对照方法,将60例住院患者按随机数字表随机分为两组。对照组30例依达拉奉,30mg/次,2次/d静点;常规护理:入院指导、观察生命体征,饮食护理、健康指导、执行医嘱、出院指导。干预组30例康复护理,①心理护理:耐心、和蔼态度及语气安抚患者情绪,倾听并与患者积极沟通,鼓励患者树立战胜疾病信心,坚持完成每日康复锻炼目标,增进医护患间信任程度。②运动护理:后遗症运动功能障碍-肢体运动康复锻炼,辅助四肢、关节、肌肉活动,逐步提高运动能力及肌力,避免废用性萎缩。③日常生活护理:指导并辅助完成日常体位变换,协助离床活动及锻炼,避免意外跌倒,夜间睡眠定时翻身并按摩肢体,改善局部循环,避免长期卧床发生褥疮及深静脉血栓;依达拉奉干预同对照组。连续干预治疗21d为1疗程。观测临床表现、神经功能损伤程度,护理满意度、不良反应。干预治疗1疗程,判定疗效。[结果]神经损伤评分两组均有改善(P<0.01),治疗组改善优于对照组(P<0.01)。护理满意度治疗组高于对照组(P<0.01)。[结论]康复护理联合依达拉奉干预脑梗后遗症期神经功能缺损,效果满意,无严重不良反应,值得推广。
[Objective] To observe the effect of rehabilitation nursing combined with edaravone on the neurological deficit in the sequela of cerebral infarction. [Methods] Sixty hospitalized patients were randomly divided into two groups according to a random number table using a random parallel control method. Thirty patients in the control group were treated with edaravone, 30 mg/time, 2 times/d static. Routine care plan:give patients admission guidance, observe patient vital signs, diet care, health guidance, executive advice,discharge guidance. 30 patients in the intervention group. Rehabilitation nursing intervention methods include: 1 psychological care: patience, awkward attitude and tone to appease the patient's nervousness,anxiety, fear, listen and actively communicate with the patient, encourage patients to establish confidence in the fight against disease, adhere to the goal of daily rehabilitation exercise, Improve the level of trust between doctors and patients. 2 sports nursing intervention: the sequelae motor dysfunction patients with limb exercise rehabilitation exercise, assist patients with limbs, joints, muscle activities, and gradually improve the patient's exercise capacity and muscle strength, to avoid long-term disuse atrophy caused by limb function can not be damaged. 3 daily life nursing intervention: guide and assist patients to complete daily body position change, assist patients to get out of bed activities and exercise, avoid accidental falls, turn over and massage limbs during nighttime sleep, improve local circulation, avoid prolonged bedridden hemorrhoids and deep vein thrombosis; Edaravone was intervened in the same control group. Continuous treatment for 21 days is a course of treatment. Observe clinical manifestations, degree of neurological impairment, clinical care satisfaction, and adverse reactions. Treatment for 1 course of treatment, to determine the efficacy. [Results]The neurological injury scores were improved in both groups(P<0.01), and the improvement in the treatment group was better than that in the control group(P<0.01). The clinical nursing satisfaction treatment group was higher than the control group(P<0.01). [Conclusion] Rehabilitation nursing combined with edaravone intervention for neurological deficits in sequelae of cerebral infarction has satisfactory curative effect and no serious adverse reactions, which is worthy of promotion.
[Objective] To observe the effect of rehabilitation nursing combined with edaravone on the neurological deficit in the sequela of cerebral infarction. [Methods] Sixty hospitalized patients were randomly divided into two groups according to a random number table using a random parallel control method. Thirty patients in the control group were treated with edaravone, 30 mg/time, 2 times/d static. Routine care plan:give patients admission guidance, observe patient vital signs, diet care, health guidance, executive advice,discharge guidance. 30 patients in the intervention group. Rehabilitation nursing intervention methods include: 1 psychological care: patience, awkward attitude and tone to appease the patient's nervousness,anxiety, fear, listen and actively communicate with the patient, encourage patients to establish confidence in the fight against disease, adhere to the goal of daily rehabilitation exercise, Improve the level of trust between doctors and patients. 2 sports nursing intervention: the sequelae motor dysfunction patients with limb exercise rehabilitation exercise, assist patients with limbs, joints, muscle activities, and gradually improve the patient's exercise capacity and muscle strength, to avoid long-term disuse atrophy caused by limb function can not be damaged. 3 daily life nursing intervention: guide and assist patients to complete daily body position change, assist patients to get out of bed activities and exercise, avoid accidental falls, turn over and massage limbs during nighttime sleep, improve local circulation, avoid prolonged bedridden hemorrhoids and deep vein thrombosis; Edaravone was intervened in the same control group. Continuous treatment for 21 days is a course of treatment. Observe clinical manifestations, degree of neurological impairment, clinical care satisfaction, and adverse reactions. Treatment for 1 course of treatment, to determine the efficacy. [Results]The neurological injury scores were improved in both groups(P<0.01), and the improvement in the treatment group was better than that in the control group(P<0.01). The clinical nursing satisfaction treatment group was higher than the control group(P<0.01). [Conclusion] Rehabilitation nursing combined with edaravone intervention for neurological deficits in sequelae of cerebral infarction has satisfactory curative effect and no serious adverse reactions, which is worthy of promotion.
引文
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[13]常伟丽.系统化护理干预对脑梗死患者身体功能恢复的影响[J].中西医结合心血管病电子杂志,2016,4(18):85-86.
[14]裴月辉.优质护理服务在老年性脑梗死护理中的应用[J].中国卫生标准管理,2015,15(17):244-245.
[15]李春生.不同剂量的重组组织型纤溶酶原激活剂静脉溶栓治疗急性脑梗死临床研究[J].中国实用神经疾病杂志,2017,20(5):108-110.
[16]邱伟庆.血浆ADMA和血小板膜糖蛋白在急性脑梗死患者中的表达及关系的研究[J].陕西医学杂志,2017,46(10):1423-1425.
[17]薛占尤,李祯,刚书成,等.依达拉奉联合低分子肝素钙治疗进展性脑梗死疗效分析[J].中国实用神经疾病杂志,2010,17(13):24-25.
[18]刘江波.急性脑梗死患者早期康复治疗不同介入时机的临床比较[J].中西医结合心血管病电子杂志,2018,6(10):84+86.
[19]吴舟娜,应红芳,何松彬.早期神经康复护理对脑梗死偏瘫患者的影响[J].浙江医学,2014,36(11):1023-1024.
[2]杨政,吴正林.治疗急性脑梗死的新型脑保护药依达拉奉[J].中国新药杂志,2002,11(12):911-913.
[3]中华人民共和国卫生部.涉及人的生物医学研究伦理审查办法(试行)[S].(2007-03-26)[2017-03-01].http://www.moh.gov.cn/qjjys/s3581/200804/b9f1bfee4ab344ec892e68097296e2a8.shtml.
[4]高长玉,吴成翰,赵建国,等.中国脑梗死中西医结合诊治指南(2017)[J].中国中西医结合杂志,2018,38(2):136-144.
[5]陈军华,邓永胜,贺建中,等.拜阿斯匹林联合阿托伐他汀预防脑梗再发的临床应用研究[J].井冈山大学学报:自然科学版,2010,31(3):95-97.
[6]李巍.针刺配合中西药治疗对脑出血术后患者神经功能康复的影响[J].中国实用神经疾病杂志,2014,17(2):12-13.
[7]罗祖明,刘凌,商惠芳.急性缺血性脑卒中病人三种神经功能缺损程度评分与巴氏指数的相关性[J].中华老年心脑血管病杂志,2001,3(4):241-243.
[8]潘江,冯华明.依达拉奉对急性脑梗死患者神经功能缺损及日常生活活动能力恢复的影响[J].河北医学,2016,22(8):1249-1251.
[9]谈颂,常思远,宋波,等.早期改良美国国立卫生研究院卒中量表评分对缺血性卒中预后的预测作用[J].中华神经科杂志,2012,45(3):154-157.
[10]脑卒中4种评定量表的效度、信度及可操作性检验[J].中国组织工程研究,2002,6(19):2846-2847.
[11]周姗含.氯吡格雷联合阿司匹林治疗缺血性脑血管病的疗效观察及其对血清低氧诱导因子-1α、半胱氨酸蛋白酶3的影响[J].中国基层医药,2017,24(9):1281-1284.
[12]郑剑煌,王燕玲,刘桂英.格拉斯哥昏迷评分法在神经外科护理工作中的应用[J].中国校医,2016,30(10):785-786.
[13]常伟丽.系统化护理干预对脑梗死患者身体功能恢复的影响[J].中西医结合心血管病电子杂志,2016,4(18):85-86.
[14]裴月辉.优质护理服务在老年性脑梗死护理中的应用[J].中国卫生标准管理,2015,15(17):244-245.
[15]李春生.不同剂量的重组组织型纤溶酶原激活剂静脉溶栓治疗急性脑梗死临床研究[J].中国实用神经疾病杂志,2017,20(5):108-110.
[16]邱伟庆.血浆ADMA和血小板膜糖蛋白在急性脑梗死患者中的表达及关系的研究[J].陕西医学杂志,2017,46(10):1423-1425.
[17]薛占尤,李祯,刚书成,等.依达拉奉联合低分子肝素钙治疗进展性脑梗死疗效分析[J].中国实用神经疾病杂志,2010,17(13):24-25.
[18]刘江波.急性脑梗死患者早期康复治疗不同介入时机的临床比较[J].中西医结合心血管病电子杂志,2018,6(10):84+86.
[19]吴舟娜,应红芳,何松彬.早期神经康复护理对脑梗死偏瘫患者的影响[J].浙江医学,2014,36(11):1023-1024.