循证护理措施对高血压脑出血患者疗效及预后的影响

Effect of evidence-based nursing on the prognosis and curative effect of patients with hypertensive cerebral hemorrhage

目的 探讨循证护理措施对高血压脑出血患者临床疗效及预后的影响.方法 选取高血压脑出血患者120例,按照随机数字表法分为观察组60例和对照组60例;对照组患者采用常规护理,观察组患者在常规护理基础上给予循证护理;比较两组护理前后抑郁自评量表（SDS）、焦虑自评量表（SAS）、美国国立卫生院神经功能缺损评分（NIHSS）、巴塞尔指数（Barthel）评分,后遗症发生率,住院时间和护理质量评分以及患者对护理的满意度.结果 护理干预前,两组SDS、SAS、NIHSS、Barthel评分差异均无统计学意义（均P＞0.05）.护理干预后,观察组SDS、SAS、NIHSS、Barthel评分分别为（38,74±6.21）分、（35.83±8.17）分、（11.24±3.08）分、（92.58±6.46）分,对照组分别为（44.58±7.10）分、（43.66±8.06）分、（15.34±3.29）分、（84.27 ±5.82）分,两组差异均有统计学意义（t=4.796、5,285、7.047、7.403,均P＜0.05）;观察组静脉血栓、肌肉萎缩和关节强直等后遗症发生率为8.33％,低于对照组的40.00％,两组差异有统计学意义（χ2=16.415,P＜0.05）;观察组住院时间（9.55±2.43）d,短于对照组的（15.97±4.68） d（t =9.430,P＜0.05）;观察组护理质量评分中健康教育评分（97.66±2.45）分、病房管理评分（98.23±3.46）分、基础护理评分（97.54±3.18）分、危重患者护理评分（96.88 ±3.49）分、护理文书书写评分（98.76±1.31）分,分别高于对照组的健康教育评分（88.79±2.37）分、病房管理评分（90.72±3.52）分、基础护理评分（91.05±3.16）分、危重患者护理评分（91.67±5.34）分、护理文书书写评分（93.04±1.12）分,两组差异均有统计学意义（t=20.156、11.786、11.214、6.326、25.707,均P＜0.05）;观察组患者护理后满意度（96.67％）高于对照组（85.00％）,两组差异有统计学意义（χ2 =4.904,P＜0.05）.结论 对高血压脑出血患者进行循证护理能有效缓解患者焦虑情绪和抑郁情绪,提高患者生活质量,降低后遗症发生率,缩短住院时间,提高患者满意度.

Objective To investigate the effect of evidence-based nursing on the clinical curative effect and prognosis of patients with hypertensive cerebral hemorrhage.Methods 120 patients with hypertensive cerebral hemorrhage were selected,and they were randomly divided into observation group（60 cases） and control group（60 cases） according to the digital table.The control group was treated with routine nursing,the observation group was treated with routine nursing and evidence-based nursing.Before and after nursing,the SDS,self rating anxiety scale （SAS）,neurological deficit score NIHSS,Barthel score,the incidence of sequelae,hospitalization time,nursing quality score and patients’ satisfaction with nursing were compared between the two groups.Results There were no statistically significant differences in SDS,SAS,NIHSS and Barthel scores between the two groups before nursing intervention（all P 〉 0.05）.After nursing intervention,the SDS,SAS,NIHSS and Barthel scores of the observation group were （38.74 ± 6.21） points,（35.83 ± 8.17） points,（11.24 ± 3.08） points,（92.58 ± 6.46） points,respectively,which in the control group were （44.58 ± 7.10） points,（43.66 ± 8.06） points,（15.34 ± 3.29） points,（84.27 ± 5.82） points,there were significant differences between the two groups （t =4.796,5.285,7.047,7.403,all P 〈0.05）.,The incidence rate of venous thrombosis,muscle atrophy and joint ankylosis sequelae of the observation group was 8.33%,which was lower than 40.00% of the control group,there was significant difference between the two groups（χ2 =16.415,P 〈 0.05）.The hospitalization time of the observation group was （9.55 ± 2.43）d,which was shorter than （15.97 ± 4.68） d of the control group （t =9.430,P 〈 0.05）.The health education nursing quality score,ward management score,basic nursing score,nursing care of critical patients score,nursing document writing score of the observation group were （97.66 ± 2.45） points,（98.23 ± 3.46） points,（97.54 ± 3.18） points,（96.88 ± 3.49） points,（98.76 ± 1.31）points,respectively,which were higher than those of the control group [（88.79 ± 2.37） points,（90.72 ±3.52） points,（91.05 ±3.16） points,（91.67 ± 5.34） points,（93.04 ± 1.12） points],there were significant differences between the two groups（t =20.156,11.786,11.214,6.326,25.707,all P 〈 0.05）.The patients’ nursing satisfaction of the observation group （96.67%） was higher than that of the control group （85.00%）,there was significant difference between the two groups （χ2 =4.904,P 〈 0.05）.Conclusion Evidence -based nursing can effectively relieve patients’ anxiety and depression of patients with hypertensive cerebral hemorrhage,improve the quality of life of patients,reduce the incidence of complications,shorten the hospitalization time,improve patients＆#39;satisfaction.