护理干预联合恩必普治疗对社区缺血性脑卒中患者生活质量的影响

Effect of comprehensive nursing intervention combined with dl-3-n-butylphthalide on the quality of life in patients with ischemic stroke in the community

目的：探讨护理干预联合恩必普治疗对社区缺血性脑卒中（AIS）患者生活质量的影响。方法选择2012年1-12月期间在济宁医学院附属医院神经内科住院的105例AIS患者。所有患者被分为三组，其中对照组（33例）给予神经内科常规二级预防标准化预防药物，随访12个月；护理干预组（34例）给予神经内科常规二级预防标准化预防药物＋护理干预，随访12个月；护理干预＋恩必普组（38例）给予神经内科常规二级预防标准化预防药物＋护理干预＋恩必普强化治疗，随访12个月。采用美国国立卫生院神经功能缺损评分（NIHSS）评分差、日常生活能力评分（ADL）增分率评价干预效果，并对研究期间12个月内缺血性脑卒中复发事件进行统计。统计学处理采用SPSS 17.0统计软件对所得数据进行分析，各测量参数以均数依标准差表示，组间比较采用单因素方差分析和F检验，两两比较采用SNK-q检验，以P〈0.05为差异有统计学意义。结果三组间NIHSS评分差差异有高度统计学意义（F=9.116，P=0.007）；护理干预组、护理干预＋恩必普组与对照组比较，差异均有统计学意义（P=0.019、0.002），护理干预组与护理干预＋恩必普组比较，差异无统计学意义（P=0.219）。三组间ADL增分率比较，差异有高度统计学意义（F=222.864，P〈0.01）；护理干预组、护理干预＋恩必普组与对照组比较，差异均有高度统计学意义（均P〈0.01），护理干预组与护理干预＋恩必普组比较，差异无统计学意义（P=0.317）。三组AIS复发事件进行χ2检验，结果显示，护理干预组、护理干预＋恩必普组与对照组比较，差异均有统计学意义（χ2=4.51，P=0.032；χ2=3.01，P=0.036），而护理干预组与护理干预＋恩必普组比较，差异无统计学意义（χ2=1.78，P〉0.05）。结论积极的护理干预可以显著改善AIS患者生活质量；应用3个疗程的恩必普治疗＋护理干预效果不明显。

Objective To investigate the effect of nursing intervention combined with dl-3-n-butylphthalide （NBP） on the quality of life in patients with ischemic stroke in the community. Methods 105 ischemic stroke patients were se-lected from the inpatient of Department of Neurology Medicine of the Affiliated Hospital of Ji’ning Medical College of from January to December 2012. They were assigned to three groups： the control group （n= 33） received standardized secondary drug prevention, following-up for 12 months;nursing intervention group （n=34） received standardized sec-ondary drug prevention combined with nursing intervention, following-up for 12 months; nursing intervention combined with NBP group （n = 38） received standardized secondary drug prevention plus NBP combined with nursing interven-tion, following-up for 12 months. The efficacy measures were evaluated by the difference of health stroke scale （NIHSS） score, the increasing rate of activity of daily living （ADL）. The recurrent event was analyzed at the 12 months. SPSS 17.0 software was used to do the statistical analysis, between the groups the results were analyzed by one-way ANOVA and F test, SNK-q test was used to compare the difference between two groups. A probability value of P 〈 0.05 was considered to be statistically significant. Results The NIHSS score difference between the three groups was statistically significant （F= 9.116, P = 0.007）; there were differences between the nursing intervention group compared with the control group and the nursing intervention combined with NBP group compared with the control group （P=0.019, 0.002）, there was no difference between the nursing intervention group and the nursing intervention combined with NBP group （P = 0.219）. The increasing rate of ADL between the three groups was significantly different （F=222.864, P〈0.01）, there were significant differences between the nursing intervention group and the nursing intervention combined with NBP group compared with the control group （P〈0.01）, there was no difference between the nursing intervention group and nursing intervention combined with NBP group （P=0.317）. AIS recurrence events between the three groups were analyzed by χ2 test, there were significant differences be-tween the nursing intervention group compared with control group and the nursing intervention combined with NBP group compared with the control group （χ2=4.51, P=0.032;χ2=3.01, P=0.036, respectively）. There was no difference between the nursing intervention group and the nursing intervention combined with NBP group （χ2=1.78, P 〈 0.05）. Conclusion Active nursing intervention in the community is efficacious to improve the quality of life and prevents the recurrent event in patients with ischemic stroke in the community, and there is no evidence that the NBP is efficacious in these patients.