循证护理干预对老年脑梗死患者肢体运动功能、语言功能及免疫炎性反应的影响

Effects of evidence-based nursing intervention on limb motor function,language function and immune inflammatory reaction of elderly patients with cerebral infarction

目的探讨循证护理干预对老年脑梗死患者肢体运动功能、语言功能及免疫炎性反应的影响。方法选取2017年5月至2017年12月就诊并接受治疗的老年脑梗死患者80例为研究对象,随机分为对照组和观察组,每组40例。对照组采用常规护理措施,观察组在常规护理基础上采用循证护理干预。分别采用神经功能缺损量表(NIHSS)、肢体运动功能评价量表(Fugl-Meyer)、汉语失语症检查表(ABC法)、Barthel评分法评估患者神经功能缺损程度、肢体运动功能、语言功能及生活质量。采用酶联免疫吸附实验(ELISA)测定血清炎性因子[超敏C-反应蛋白(hs-CRP)、白细胞介素6(IL-6)、肿瘤坏死因子-α(TNF-α)]含量。流式细胞术测定外周血T淋巴细胞亚群(CD_3^+、CD_4^+、CD_8^+比例及CD_4^+/CD_8^+)。结果 2组护理前NIHSS、Fugl-Meyer、ABC、Barthel评分、血清hs-CRP、IL-6、TNF-α含量、外周血CD_3^+、CD_4^+、CD_8^+比例及CD_4^+/CD_8^+比较差异无统计学意义(P>0.05);2组护理后NIHSS评分、血清hsCRP、IL-6、TNF-α含量及外周血CD_8^+比例均较护理前明显降低,Fugl-Meyer、ABC、Barthel评分、外周血CD_3^+、CD_4^+比例及CD_4^+/CD_8^+均较护理前明显提高,差异有统计学意义(P<0.05),且观察组改善程度优于对照组,差异有统计学意义(P<0.05)。结论老年脑梗死患者采用循证护理干预能够有效提高患者肢体运动功能和语言功能,改善患者生活质量和免疫功能,并降低血清炎性因子含量,值得临床推广。

Objective To investigate the effects of evidence-based nursing intervention on limb motor function,language function and immune inflammatory reaction of elderly patients with cerebral infarction. Methods Eighty elderly patients with cerebral infarction who were treated in our hospital from May 2017 to Dec 2017 were randomly divided into observation group（ n = 40） and control group（ n = 40）. The patients in control group were treated by routine nursing,however,the patients in observation group,on the basi of control group,were treated by evidence-based nursing intervention.NIHSS,Fugl-Meyer,ABC and Barthel scores were used to evaluate the degree of nervous function deficiency,limb motor function,language function and life quality of patients,moreover,the serum levels of hs-CRP,IL-6 and TNF-αwere detected by ELISA,and the percentages of CD_3~＋ T,CD_4~＋ T,CD_8~＋ T cells and CD_4~＋/CD_8~＋ were measured by flow cytometry. Results Before nursing intervention,there were no significant differences in scores of NIHSS,Fugl-Meyer,ABC and Barthel,and the serum levels hs-CRP,IL-6 and TNF-α,the percentages of CD_3~＋,CD_4~＋,CD_8~＋ and CD_4~＋/CD_8~＋ between two groups（ P〈0. 05）. After nursing intervention,the NIHSS scores,serum levels of hs-CRP,IL-6 and TNF-α and the percentage of CD_8~＋ in observation group were significantly decreased in both groups,and the scores of Fugl-Meyer,ABC and Barthel,the percentages of CD_3~＋,CD_4~＋ and CD_4~＋/CD_8~＋ were significantly increased in both groups,moreover,the the improvement degree in observation group was superior to that in control group（ P〈0. 05）. Conclusion The evidence-based nursing intervention in treatment of cerebral infarction in the elderly patients can obviously improve limb motor function,language function,life quality and immune function of patients,and can inflammatory cytokines levels,therfor,which is worthy of promotion in clinical practice.