分级护理在危重脑卒中患者中的应用效果

Application effect of grading nursing in critically ill stroke patients

目的：探讨分级护理在危重脑卒中患者中的应用效果。方法选取2014年5月—2016年1月武汉大学中南医院收治的危重脑卒中患者104例,依据入院时间分为观察组（分级护理）和对照组（常规护理）,比较两组患者护理前后的Barthel评分、NIHSS评分、Fugl-Meyer评分、护理效果及不良事件发生率。结果护理前,两组患者的Barthel评分、NIHSS评分、Fugl-Meyer评分差异均无统计学意义（ t值分别为0.779,1.652,1.315；P〉0.05）。护理后,观察组的Barthel评分、Fugl-Meyer评分明显高于对照组,NIHSS评分低于对照组,差异有统计学意义（ t值分别为2.330,2.079,2.748；〈0.05）；观察组患者积极配合率、自护方法掌握率、护理有效率、护理满意度均高于对照组,差异有统计学意义（χ^2值分别为6.349,3.915,8.796,5.024；〈0.05）；观察组误吸、呛咳、院内感染、压疮、死亡发生率均低于对照组,差异有统计学意义（χ^2值分别为7.013,3.893,5.568,2.905,4.392；〈0.05）。结论分级护理能够明显改善危重脑卒中患者的肢体运动能力和神经功能,降低误吸、感染等不良事件发生率。

Objective To investigate the application effect of grading nursing in critically ill stroke patients. Methods Totally 104 critically ill stroke patients admitted in Zhongnan Hospital of Wuhan University from May 2014 to January 2016 were selected and assigned to the control group （ routine nursing） and the observation group （grading nursing） randomly according to the time of admission. The Barthel score, score of national institutes of health stroke scale （NIHSS） , Fugl-Meyer score, nursing effect, and the incidence of adverse events in two groups were compared. Results Before nursing intervention, there was no significant difference in Barthel score, NIHSS score and Fugl-Meyer score between two groups （P〉0.05）. After nursing intervention, the Barthel score and Fugl-Meyer score in the observation group were significantly higher than that in the control group, and the NIHSS score was significantly lower than that in the control group （P〈0.05）. The rate of actively cooperation, the master rate of self-care method, the effective rate of nursing and the nursing service satisfaction in the observation group was higher than that in the control group （P〈0.05）. The incidence of aspiration, cough, nosocomia｜ infection, pressure ulcers and death in the observation group was lower than that in the control group （ P 〈 0.05 ）. Conclusions Grading nursing can significantly improve neurological function and capacity of physical exercise in critically ill stroke patients, and reduce the incidence of aspiration, infections and other adverse events, so it is worthy of promotion.