循证护理联合健康教育护理对动脉瘤性蛛网膜下腔出血患者认知功能恢复的影响

Efficacy of evidence-based nursing combined with health education on the recovery of cognitive function in patients with subarachnoid hemorrhage

目的探讨循证护理联合健康教育对动脉瘤性蛛网膜下腔出血患者认知功能恢复的影响。方法选取2011年10月至2015年1月间收治的120例动脉瘤性蛛网膜下腔出血患者,采用随机数字表法分为观察组和对照组,每组60例。观察组患者行循证护理联合健康教育护理,对照组患者行健康教育护理。观察两组患者洛文斯顿作业疗法认知成套测试(LOTCA)评分量化表、简易智力状态检查表(MMES)和日常生活活动能力(ADL)评分,同时对两组患者并发症发生率及预后情况进行分析。结果观察组患者在ADL、MMES及LOTCA的量化评分显著高于对照组(均P<0.01)。观察组患者脑血管痉挛、再出血及头痛发生率分别为3.3%、3.3%和1.7%,明显低于对照组的25.0%、13.3%和13.3%(P=0.002、P=0.048、P=0.015)。两组患者泌尿系统感染和压疮发生率的差异无统计学意义(P>0.05),观察组患者痊愈率为51.7%,明显高于对照组的30.0%(P=0.026)。观察组患者死亡率为3.3%,明显低于对照组的15.0%(P=0.027)。结论采用循证护理联合健康教育对动脉瘤性蛛网膜下腔出血患者的认知功能障碍恢复的影响重大,效果明显,具有重要的临床应用价值。

Objective To discuss the effect of evidence-based nursing combined with health educa- tion on the recovery of cognitive function in patients with subarachnoid hemorrhage. Methods 120 cases of aneurysmal subarachnoid hemorrhage treated from October 2011 to January 2015 were selected and divided into the observation group and the control group, with 60 cases in each group. Patients in the observation group were given evidence-based nursing combined with health education, while the control group was only given health education. Quantitative scores of activities of daily living （ADL）, mental status （MMES） and cognitive function （LOTCA） of the two groups were observed. The complication rate and prognosis of the two groups were analyzed. Results ADL, MMES and LOTCA of the observation group were significantly higher than those of the control group （ all P 〈0.01 ）. The incidence rates of cerebral vasospasm, rebleed- ing and headache of the observation group were respectively 3.3% , 3.3% and 1.7%, which were signifi- cantly lower than the control group （25.0%, 13.3% and 13.3% ） （P =0. 002, P =0. 048, P =0. 015）. But there were no differences of urinary tract infections and pressure sores between the two groups （P 〉 0. 05 ）. Mortality of the observation group was 3.3%, which was significantly lower than 15.0% of the con- trol group （P = 0. 027）. Conclusions The effect of evidence-based nursing combined with health educa- tion on cognitive function of patients with aneurysmal subarachnoid hemorrhage is significant and very obvi-ous. It has important clinical value.