五常法管理模式联合人性化护理措施应用于高血压性脑出血的效果分析

Effect of five regular methods management model combined with humanized nursing measures applied to hypertensive intracerebral hemorrhage

目的评价五常法管理模式结合人性化护理对高血压性脑出血患者血清炎症因子的影响和预后影响。方法选取自2014年5月1日—2017年6月1日间来丽水市中心医院接受高血压性脑出血患者46例作为研究对象,该研究为随机、盲法、对照试验,按随机数字表法将其随机分为A组(单纯人性化护理)、B组(五常法护理管理模式联合人性化护理)各23例,选取同时期来院接收健康体检的健康者23例作为C组(健康对照组)。观察A、B组患者术后不同时间生命指征的变化情况,术后相关促炎因子的表达水平;观察A、B、C 3组患者简易精神状态检查表(minimum mental state examination,MMSE)评分。结果 B组患者相关生命指标变化较A组平稳;2组患者术后24 h血清炎症因子IL-1、IL-6、IL-10和TNF-α显著升高,但B组患者血清IL-1、IL-6和TNF-α显著低于A组,差异均有统计学意义(均P<0.05);B组患者术后24 h定向能力、记忆能力、回忆能力以及注意计算能力均显著低于C组,但仍高于A组患者,差异均有统计学意义(均P<0.05)。MMSE各评分项与IL-1、IL-6和TNF-α存在明显的负相关关系,与IL-10不相关。结论五常法护理管理联合人性化护理措施能够改善护理质量从而稳定高血压性脑出血患者血清相关炎症因子的高表达,对生命体征以及意识恢复有一定效果。

Objective To evaluate the effect of five regular methods management model combined with humanistic nurs- ing on serum inflammatory factors in patients with hypertensive cerebral hemorrhage and its prognostic impact. Methods A total of 46 hypertensive intracerebral hemorrhage patients who underwent cerebellar decompression in our hospital from May 1, 2014 to June 1, 2017 were selected as study subjects. The study was randomized, blinded, and controlled. According to the random number table method, they were randomly divided into two groups ： A （ user-friendly nursing） and B （five regular methods nursing management mode combined with humanized nursing）. We selected 23 healthy people who received physical examination in our hospital at the same time as group C （ healthy control group）, observed the changes of the vital signs at different time after operation in A and B groups ; observed the expression levels of postoperative pro-inflammatory factors in A and B groups; observed the simple mental status checklists （Minimum mental state examination, MMSE）in patients A, B, and C scores. Results The changes of related vital indexes in group B were more stable than those in group A. Serum inflammatory cytokines IL-1, IL-6, IL-10 and TNF-α were significantly elevated at 24 h after operation in group B, but the levels of IL-1, IL-6 and TNF-α were significantly lower than those in group A （P 〈 0.05）. After 24 hours, the directional ability, memory ability, recall ability, and attention calculation a- bility of group B patients were significantly lower than those of group C, but still higher than those of group A patients, with statistical significance （P 〈 0.05）. There was a significant negative correlation between MMSE scores and IL-1, IL- 6 and TNF-α, and no correlation with IL-10. Conclusion The five regular methods nursing management combined with humanized nursing measures can improve the quality of nursing and stabilize the high expression of serum-related inflam- matory factors in patients with hypertensive cerebral hemorrhage, thus having certain effects on vital signs and conscious- ness recovery.