早期护理干预在腔隙性脑梗死认知功能康复的效果研究

Effect of early nursing intervention on cognitive function rehabilitation in patients with lacunar cerebral infarction

目的 探讨早期护理干预对腔隙性脑梗死患者认知功能障碍康复的效果.方法 选择90例符合纳入标准的腔隙性脑梗死住院患者,使用中文版蒙特利尔认知评估（MoCA）量表进行认知功能障碍评分,将评分＜ 26分的患者随机分为实验组和对照组,对照组给予常规的认知康复护理,干预组予制定个体化认知功能康复护理以及手指操训练3个月,在15天、1月、2月、3月分别对两组进行认知功能康复测评.结果 实验组MoCA量表得分及视空间与执行功能、注意、抽象等认知功能评分在分组、时间、时间和分组的交互作用上差异均有统计学意义（P＜0.05）,记忆、定向两项在时间、时间和分组的交互作用上差异有统计学意义（P＜0.05）,分组与康复时间存在交互效应,随着时间的推进,两组干预效果差异有统计学意义.语言、命名方面两组差异无统计学意义（P＞0.05）.结论 早期护理干预对腔隙性脑梗死认知功能障碍的患者认知康复有良好的效果,值得推广.

Objective To explore the effect of early nursing intervention on cognitive function rehabilitation in patients with lacunar cerebral infarction.Methods 90 inpatients meeting the inclusion criteria of lacunar cerebral infarction were selected.Chinese version of Montreal cognitive assessment （MoCA） scale were used to evaluate cognitive dysfunction.The patients whose MoCA scores were below 26 were randomly divide into an experimental group and a control group.The control group received conventional cognitive rehabilitation nursing care,and the experimental group individualized rehabilitation nursing care and cognitive function finger exercise training for 3 months.Cognitive function rehabilitation evaluation was carried out in both group 15 days and 1,2,and 3 months from then.Results There were statistical differences in MoCA score and the scores of visual space,executive,attentiona,and abstract functions in the experimental group （MoCA） to the group division,time,and the interaction between time and group division（P〈0.05）.There was statistical significance in the interaction of memory and direction in terms of time and group division （P〈0.05）.Grouping and recovery time had interactive effect.With the advance of time,the effect of the two intervention groups differed from each other.As for Language and naming,the two groups had no statistical significance （P〉0.05）.Conclusions Early nursing intervention for patients with lacunar cerebral infarction having cognitive impairment and undergoing cognitive rehabilitation is effective and is worth being generalized.