【摘要】：目的:闡明護(hù)理干預(yù)措施在缺血性腦卒中偏癱患者急性期病情恢復(fù)過(guò)程中的作用及影響,篩選缺血性腦卒中偏癱患者急性期恢復(fù)效果的影響因素,為臨床缺血性腦卒中患者急性期個(gè)體化護(hù)理干預(yù)方案提供參考。方法:149例缺血性腦卒中偏癱患者均選自山西省某三級(jí)甲等醫(yī)院神經(jīng)內(nèi)科,基于目前臨床常規(guī)的腦卒中治療方案,將患者根據(jù)護(hù)理康復(fù)方案情況不同分為護(hù)理+針灸治療組、護(hù)理+康復(fù)治療組及護(hù)理+針灸康復(fù)聯(lián)合治療組(以下簡(jiǎn)稱(chēng)護(hù)理+聯(lián)合康復(fù)組)三組。在護(hù)理干預(yù)前根據(jù)統(tǒng)一設(shè)計(jì)的Epi Data數(shù)據(jù)庫(kù)收集所有患者的資料,包括人口學(xué)特征指標(biāo),生活行為習(xí)慣,既往疾病史與家族史,入院時(shí)的實(shí)驗(yàn)室檢測(cè)指標(biāo),梗死類(lèi)型及梗死部位,入院治療前的MBI及NIHSS評(píng)分等資料,并于患者出院時(shí)再次收集MBI及NIHSS評(píng)分。對(duì)患者急性期恢復(fù)效果的分析采用重復(fù)測(cè)量資料方差分析法,影響急性期恢復(fù)效果的因素分析采用logistic回歸分析法。結(jié)果:在臨床上常規(guī)治療與護(hù)理干預(yù)前,護(hù)理+針灸治療組,護(hù)理+康復(fù)治療組,護(hù)理+聯(lián)合康復(fù)組三組患者的一般情況基本相近,人口學(xué)特征指標(biāo)、生活行為習(xí)慣、既往疾病史與家族史、入院時(shí)實(shí)驗(yàn)室檢測(cè)指標(biāo)等情況分布基本均衡。護(hù)理+針灸治療組,護(hù)理+康復(fù)治療組,護(hù)理+聯(lián)合康復(fù)組三組患者治療前MBI及NIHSS評(píng)分有差別,認(rèn)為三組患者在治療前的基本病情程度不同,護(hù)理+針灸治療組患者在治療前的病情程度遠(yuǎn)比護(hù)理+康復(fù)治療組及護(hù)理+聯(lián)合康復(fù)組的患者輕,護(hù)理+康復(fù)治療組及護(hù)理+聯(lián)合康復(fù)組患者在治療前的病情程度尚不能認(rèn)為有差別。護(hù)理+針灸治療組,護(hù)理+康復(fù)治療組及護(hù)理+聯(lián)合康復(fù)組三組患者治療前后的MBI評(píng)分經(jīng)比較,F=133.237,P0.001,說(shuō)明不同治療組患者治療前后的MBI評(píng)分有差別,護(hù)理+針灸治療組患者M(jìn)BI得分提高幅度更大。護(hù)理+針灸治療組,護(hù)理+康復(fù)治療組及護(hù)理+聯(lián)合康復(fù)組三組患者治療前后的NIHSS評(píng)分經(jīng)比較,F=70.497,P0.001,說(shuō)明不同治療組患者治療前后的NIHSS評(píng)分有差別,三組患者NIHSS分值變化幅度的差別無(wú)統(tǒng)計(jì)學(xué)意義。年齡、護(hù)理+常規(guī)治療分組及治療前NIHSS評(píng)分是影響患者治療后MBI評(píng)分的有意義因素。60歲及以上的患者急性期的恢復(fù)效果不如60歲以下的患者好,OR值為0.403;護(hù)理+康復(fù)治療組患者的恢復(fù)效果較護(hù)理+針灸治療組的患者好,OR值為9.616;護(hù)理+聯(lián)合康復(fù)組患者的恢復(fù)效果較護(hù)理+針灸治療組的患者好,OR值為2.235;治療前NIHSS評(píng)分低患者的恢復(fù)效果較治療前NIHSS評(píng)分高的患者好,OR值為0.126。護(hù)理+常規(guī)治療分組及治療前NIHSS評(píng)分是影響患者治療后NIHSS評(píng)分的有意義因素。護(hù)理+康復(fù)治療組患者急性期的恢復(fù)效果較護(hù)理+針灸治療組的患者好,OR值為5.947;護(hù)理+聯(lián)合康復(fù)組患者的恢復(fù)效果較護(hù)理+針灸治療組的患者好,OR值為1.513;治療前NIHSS評(píng)分低患者的恢復(fù)效果較治療前NIHSS評(píng)分高的患者好,OR值為1.161。結(jié)論:MBI及NIHSS評(píng)分既是評(píng)價(jià)患者病情程度的指標(biāo),也是反映患者急性期護(hù)理干預(yù)效果的指標(biāo)。基于臨床治療護(hù)理的現(xiàn)狀,護(hù)理+針灸治療組、護(hù)理+康復(fù)治療組及護(hù)理+聯(lián)合康復(fù)組三組患者治療護(hù)理干預(yù)前后的MBI及NIHSS評(píng)分有差別,急性期護(hù)理干預(yù)提高了患者的恢復(fù)效果。年齡、護(hù)理+常規(guī)治療分組及治療前NIHSS評(píng)分是影響患者治療后MBI評(píng)分的有意義因素。護(hù)理+常規(guī)治療分組及治療前NIHSS評(píng)分是影響患者治療后NIHSS評(píng)分的有意義因素。
[Abstract]:Objective: To clarify the effect and influence of nursing intervention on the recovery of hemiplegic patients with ischemic stroke in acute phase, and to screen the influencing factors of the recovery effect of hemiplegic patients with ischemic stroke in acute phase, so as to provide reference for individualized nursing intervention in acute phase of ischemic stroke. Patients with hemiplegia were selected from the Department of Neurology of a Grade A hospital in Shanxi Province. Based on the current clinical routine treatment of stroke, the patients were divided into three groups according to the different nursing rehabilitation programs: nursing + acupuncture treatment group, nursing + rehabilitation treatment group and nursing + acupuncture rehabilitation combined treatment group (hereinafter referred to as nursing + rehabilitation group). Before the intervention, all patients'data were collected according to the uniformly designed Epi Data database, including demographic characteristics, living habits, past disease history and family history, laboratory tests at admission, type and location of infarction, MBI and NIHSS scores before admission, and MBI and NIH were collected again at discharge. Results: Before routine treatment and nursing intervention, nursing + acupuncture treatment group, nursing + rehabilitation treatment group and nursing + combined rehabilitation group were in general. The distribution of demographic characteristics, living habits, past disease history and family history, and laboratory tests at admission were basically balanced. There were differences in MBI and NIHSS scores between the three groups before treatment. The degree of the disease is different. the degree of the patients in the nursing + acupuncture group before treatment is much lighter than that in the nursing + rehabilitation group and the nursing + rehabilitation group. the degree of the patients in the nursing + rehabilitation group and the nursing + rehabilitation group before treatment can not be considered to be different. The MBI scores of the three groups before and after treatment were compared, F=133.237, P 0.001, indicating that the MBI scores of the patients in the different treatment groups before and after treatment were different, and the MBI scores of the patients in the nursing + acupuncture treatment group increased by a greater margin. SS score was compared, F = 70.497, P 0.001, indicating that different treatment groups before and after treatment NIHSS score difference, three groups of patients with NIHSS score changes in the range of no significant difference. The recovery effect of the nursing + rehabilitation group was better than that of the nursing + acupuncture group, the OR value was 0.403; the recovery effect of the nursing + rehabilitation group was better than that of the nursing + acupuncture group, the OR value was 9.616; the recovery effect of the nursing + rehabilitation group was better than that of the nursing + acupuncture group, the OR value was 2.235; the recovery effect of the patients with low NIHSS score before treatment was better than that of the treatment group. The patients with high NIHSS score before treatment had a better OR value of 0.126. Nursing + routine treatment group and NIHSS score before treatment were the significant factors affecting NIHSS score after treatment. Conclusion: MBI and NIHSS scores are not only indicators to evaluate the degree of illness, but also indicators to reflect the effect of nursing intervention in the acute phase of patients. There were differences in MBI and NIHSS scores before and after nursing intervention among the nursing + acupuncture treatment group, nursing + rehabilitation treatment group and nursing + combined rehabilitation group. Nursing intervention at acute stage improved the recovery effect of the patients. The treatment group and the NIHSS score before treatment were significant factors influencing the NIHSS score after treatment.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R743.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 王雷;熊曉星;簡(jiǎn)志宏;;年齡和性別因素對(duì)缺血性腦卒中的影響研究進(jìn)展[J];國(guó)際神經(jīng)病學(xué)神經(jīng)外科學(xué)雜志;2017年01期

2 徐磊;華啟海;閻興洲;江勇;王敏;;針灸結(jié)合康復(fù)訓(xùn)練治療中風(fēng)后偏癱的臨床研究[J];中華全科醫(yī)學(xué);2016年10期

3 張長(zhǎng)偉;;針灸聯(lián)合康復(fù)療法治療腦血管意外后偏癱臨床療效觀察[J];河南醫(yī)學(xué)研究;2016年10期

4 邵鳳玲;;腦梗死偏癱患者早期康復(fù)護(hù)理干預(yù)效果評(píng)價(jià)[J];內(nèi)科;2016年02期

5 凌素連;趙桂艷;;急性缺血性腦卒中早期康復(fù)護(hù)理研究進(jìn)展[J];中國(guó)當(dāng)代醫(yī)藥;2016年08期

6 鄭薏;柳維林;上官豪;王鮮;林云嬌;林梅琴;陶靜;;針灸治療腦卒中患者肢體運(yùn)動(dòng)功能障礙療效的Meta分析[J];中國(guó)康復(fù)醫(yī)學(xué)雜志;2016年02期

7 梁秀莉;;護(hù)理干預(yù)對(duì)急性缺血性腦卒中患者預(yù)后影響[J];遼寧中醫(yī)藥大學(xué)學(xué)報(bào);2016年02期

8 馬磊;宋鑫;李美;張靜;;肌電生物反饋療法針對(duì)股內(nèi)側(cè)斜肌訓(xùn)練對(duì)髕股關(guān)節(jié)疼痛綜合征的治療作用[J];中國(guó)運(yùn)動(dòng)醫(yī)學(xué)雜志;2015年12期

9 吳相慰;;序貫康復(fù)護(hù)理改善腦卒中后認(rèn)知功能障礙患者認(rèn)知功能的效果觀察[J];內(nèi)科;2015年06期

10 杜偉;;腦卒中患者急性期末的神經(jīng)功能缺損程度相關(guān)因素分析[J];中國(guó)實(shí)用神經(jīng)疾病雜志;2015年20期

相關(guān)碩士學(xué)位論文 前1條

1 劉莉莉;急性缺血性腦卒中患者早期康復(fù)臨床研究[D];蘇州大學(xué);2016年

，

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