神经功能导向式个体化干预在脑出血康复期患者中的应用

doi:10.3760/cma.j.issn.1007-1245.2023.13.030

摘要/Abstract

摘要：

目的　使用神经功能导向式个体化干预方式应用于脑出血康复期患者，探讨其对患者精神状况和运动功能的影响。方法　本研究为随机对照试验。选取2020年2月至2022年1月南阳市第一人民医院收治的脑出血康复期112例开展前瞻性研究，根据随机数字表法分为导向组和传统组。导向组56例，男34例，女22例，年龄（64.51±6.79）岁；传统组56例，男33例，女23例，年龄（65.66±6.03）岁。传统组采用常规护理措施，导向组给予神经功能导向式个体化干预。比较两组患者干预前后神经功能缺损评分量表（Nerve Functional Insufficent，NFI）、Fugl-Meyer运动功能评分量表（FMA）、简易精神状态量表（MMSE）评分，比较两组患者依从性，对两组患者抑郁自评量表（SDS）和生存质量特异性量表（QSQL）评分进行比较，观察两组患者不良反应发生情况，统计两组患者护理满意度。采用χ²检验、t检验。结果　干预后导向组NFI评分低于传统组［（9.92±1.06）分比（13.88±1.43）分］，FMA、MMSE评分高于传统组［（89.32±8.58）分比（61.39±5.16）分、（28.39±3.03）分比（24.45±2.68）分］（均P<0.05）。导向组患者健康饮食、遵嘱用药、康复运动锻炼和遵嘱复诊评分均高于传统组（t=17.896、18.098、22.591、17.028，均P<0.001）。干预后导向组SDS和QSQL评分低于传统组［（41.52±5.37）分比（49.38±4.17）分、（13.57±1.22）分比（23.32±2.19）分］（均P<0.05）。导向组患者不良反应发生率［5.36%（3/56）］明显低于传统组［19.64%（11/56）］（χ²=5.224，P=0.022）。导向组患者护理总满意度［96.43%（54/56）］明显高于传统组［78.57%（44/56）］（χ²=8.163，P=0.004）。结论　通过神经功能导向式个体化干预，脑出血康复期患者神经功能缺损程度明显改善，运动功能和生活质量明显提高，不良反应明显减少，值得推广。

关键词:

脑出血, 康复期, 神经功能, 个体化干预, 应用效果

Abstract:

Objective　To explore the influence of neurofunction-oriented individualized intervention on the mental state and motor function in patients recovering from cerebral hemorrhage. Methods　This study was a randomized controlled trial. A total of 112 cases of cerebral hemorrhage during the rehabilitation period in Nanyang First People's Hospital from February 2020 to January 2022 were selected for a prospective study, and were divided into a guided group and a traditional group according to the random number table method. The guided group consisted of 56 patients, including 34 males and 22 females, aged (64.51±6.79) years; the traditional group consisted of 56 patients, including 33 males and 23 females, aged (65.66±6.03) years. Conventional nursing measures were used in the traditional group, and neurofunction-oriented individualized intervention was used in the guided group. The scores of Nerve Functional Insufficent (NFI), Fugl-Meyer Motor Function Assessment (FMA), and Mini-mental State Examination (MMSE) before and after intervention were compared between the two groups, and the compliance of the two groups was compared. The scores of Self-rating Depression Scale (SDS) and Quality of Life Specific Scale (QSQL) were compared between the two groups, the occurrence of adverse reactions was observed in the two groups, and the nursing satisfaction of the two groups was analyzed. χ² test and t test were used. Results　After intervention, the NFI score of the guided group was lower than that of the traditional group [(9.92±1.06) points vs. (13.88±1.43) points], while the scores of FMA and MMSE were higher than those of the traditional group [(89.32±8.58) points vs. (61.39±5.16) points, (28.39±3.03) points vs. (24.45±2.68) points] (all P<0.05). The scores of healthy diet, medication compliance, rehabilitation exercise, and follow-up visit in the guided group were higher than those in the traditional group (t=17.896, 18.098, 22.591, and 17.028; all P<0.001). The SDS and QSQL scores of the guided group after intervention were lower than those of the traditional group [(41.52±5.37) points vs. (49.38±4.17) points, (13.57±1.22) points vs. (23.32±2.19) points] (both P<0.05). The incidence of adverse reactions in the guided group was significantly lower than that in the traditional group [5.36% (3/56) vs. 19.64% (11/56)] (χ²=5.224, P=0.022). The total nursing satisfaction in the guided group was significantly higher than that in the traditional group [96.43% (54/56) vs. 78.57% (44/56)] (χ²=8.163, P=0.004). Conclusion　The neurofunction-oriented individualized intervention can significantly improve the degree of neurological deficit, motor function, and quality of life, and reduce adverse reactions in patients with cerebral hemorrhage during the rehabilitation period, which is worthy of further promotion and application.

Key words:

Cerebral hemorrhage, Rehabilitation period, Neurofunction, Individualized intervention, Application effect

丁军艳魏明明李玉先.

神经功能导向式个体化干预在脑出血康复期患者中的应用 [J]. 国际医药卫生导报, 2023, 29(13): 1905-1909.

Ding Junyan, Wei Mingming, Li Yuxian.

Application of neurofunction-oriented individualized intervention in patients recovering from cerebral hemorrhage [J]. International Medicine and Health Guidance News, 2023, 29(13): 1905-1909.

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