康复护理干预对脑卒中患者恢复期心理状态、生命质量、肢体运动功能、血流变学及炎性因子的影响

Effect of rehabilitation nursing intervention on mental state,life quality,motor function,blood rheology and inflammatory factors of stroke patients in recovery period

目的探讨康复护理干预对脑卒中患者恢复期心理状态、生命质量、肢体运动功能、血流变学及炎性因子的影响。方法脑卒中恢复期患者129例,男86例,女43例。随机分为两组,对照组56例,观察组73例。两组一般资料比较,P>0.05。对照组采用常规护理。观察组在对照组的基础上按照"同伴群体论"的原则安排床位,梳理经络并配以头项针灸。两组患者于护理前、护理30天后采用汉密尔顿抑郁量表评价抑郁情况,焦虑自评量表、匹斯堡睡眠质量指数评价睡眠和Barthel指数积分法评价日常生活能力,Fugl-Meyer运动功能积分法评价运动功能,SF-36量表评价生命质量,脑卒中特定生存质量量表评价生存质量等。两组护理前、护理30天后抽晨起静脉血检测血流变学及炎性因子水平变化。所获数据均采用方差分析、t检验和2检验。结果对照组护理干预前后HAMD、SAS、PSQI、Barthel、Fugl-Meyer评分变化比较,P均<0.0005。观察组护理干预前后HAMD、SAS、PSQI、Barthel、Fugl-Meyer评分变化比较,P均<0.0005。两组护理干预后HAMD、PSQI、SAS、Barthel、FuglMeyer评分变化比较,P均<0.0005。对照组护理干预前后PF、RP、SF、RE评分变化比较,P均<0.05;BP、VT、MH评分变化比较,P均<0.0005;GH评分变化比较,P>0.05。观察组护理干预前后PF、RP、BP、GH、VT、SF、RE、MH评分变化比较,P均<0.0005。两组护理干预后PF、RP、BP、GH、VT、SF、RE、MH评分变化比较,P均<0.0005。对照组护理干预前后血浆黏度、低切血黏度、Fib水平变化比较,P均<0.0005;高切血黏度水平变化比较,P<0.001。观察组护理干预前后血浆黏度、低切血黏度、高切血黏度、Fib水平变化比较,P均<0.0005。两组护理干预后血浆黏度、低切血黏度、高切血黏度、Fib水平变化比较,P均<0.0005。对照组治疗前后IL-6、IL-10、IL-18、TNF-α水平变化比较,P均<0.0005。观察组治疗前后IL-6、IL-10、IL-18、TNF-α水平变化比较,P均<0.0005。两组治疗后IL-6、IL-18、TNF-α水平变化比较,P均<0.0005;IL-10水平变化比较,P>0.05。结论康复护理干预对脑卒中患者恢复期心理状态、生命质量、肢体运动功能、血流变学及炎性因子均有较好作用。

Objective To explore the effect of rehabilitation nursing intervention on mental state, life quality, motor function, hemorheology and inflammatory factors of stroke patients in recovery period. Methods There were 129 cases of stroke patients in recovery period, 86 males and 43 females. They were randomly divided into two groups, 56 cases in the control group and 73 cases in the observation group. The general data comparison between the two groups was P〉0.05. The control group was given routine nursing. On the basis of routine nursing, the observation group got the bed arrangement according to the principle of ＂peer group theory＂ and got collaterals and collaterals dredging combined with head acupuncture and moxibustion. Hamilton depression scale was used to evaluate depression; self rating anxiety scale and Pittsburgh sleep quality index was used to evaluate sleep; Barthel index method was used to evaluate the ability of daily life, Fugl-Meyer in- tegral method was used to evaluate motor function, SF-36 scale was used to evaluate the quality of life; stroke specific life quality evaluation scale was used before and 30 days after nursing intervention. The venous blood was drawn to test the changes of blood rheology and inflammatory factors in two groups before and 30 days after nursing intervention. The data was analyzed by variance analysis, t test and Z2 test. Results The comparison of HAMD, SAS, PSQI, Barthel and Fugl- Meyer scores in the control group before and after the nursing intervention was P〈0.0005. The comparison of those scores in the observation group before and after nursing intervention was P〈0.0005. The comparison of those scores between the two groups before and after nursing intervention was P〈0.0005. The comparison of PF, RP, SF and RE scores in the control group before and after the nursing intervention were all P〈0.05; the changes of BP, VT and MH scores were compared with all P〈0.0005; the changes of GH was compared with P〉0.05. In the observation group, the scores of PF, RP, BP, GH,VT, SF,RE and MH were compared before and after nursing intervention with P〈0.0005. The scores of PF, RP, BP, GH, VT, SF, RE and MH were compared between the two groups after intervention with P〈0.0005. Comparison of plasma viscosity, low shear blood viscosity changes and the level of Fib in the control group befor and after intervention was P〈0.0005; the comparison of high blood viscosity was P〈0.001. The comparison of plasma viscosity, low shear blood viscosity, high blood viscosity and the change of Fib level in the observention group befor and after intervention were P〈0.0005. The comparison of plasma viscosity, low shear blood viscosity, high blood viscosity and the change of Fib level between the two groups befor and after intervention were P〈0.0005. The levels of IL-6, IL-10, IL-18 and TNF- alpha in the control group were compared before and after treatment with P〈0.0005. The levels of IL-6, IL-10, IL-18 and TNF- alpha in the observation group were compared before and after treatment with P 〈0.0005. The levels of IL-6, IL-18 and TNF- alpha were compared between the two groups with P〈0.0005; the level of IL-10 was compared with P〉0.05. Conclusion Rehabilitation nursing intervention has a good effect on mental state, life quality, motor function, hemorrheology and inflammatory factors of stroke patients in recovery period.