集中式护理干预对脑梗死病人独立生活能力和白介素-6及肿瘤坏死因子-α水平的影响

Effects of centralized nursing intervention on the independent living capacity and the levels of IL-6 and TNF-α in patients with cerebral infarction

目的探讨集中式护理干预对脑梗死病人独立生活能力、白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)水平的影响。方法选取郑州大学附属洛阳中心医院2016年3月至2017年3月间收治的122例脑梗死病人作为研究对象。按照随机数字表法将病人分为对照组和观察组,各61例。两组病人均给予抗血小板、改善脑循环、营养神经及相关合并症等常规治疗,对照组病人给予常规护理干预,观察组病人给予集中式护理干预。观察两组病人护理干预3个月后病人独立生活能力、血浆白介素-6及肿瘤坏死因子-α水平情况。结果观察组病人护理干预后简式Fugl-Meye肢体评分(63.57±12.53)分、改良Barthel指数(MBI)(83.07±9.21)分明显高于对照组Fugl-Meye(57.33±11.44)分、MBI(72.11±8.27)分(t/P=2.872/0.005,6.915/0.000)。观察组病人护理干预后血清IL-6[(28.53±5.37) pg/mL]、TNF-α[(1.53±0.67) pg/mL]均明显低于对照组IL-6[(37.34±4.84) pg/mL]、TNF-α[(2.47±0.71) pg/mL](t=9.518,7.520,均P=0.000)。观察组病人总有效率91.80%明显高于对照组77.05%(χ~2=5.050,P=0.024)。结论集中式的护理干预对于提高脑梗死病人的运动功能、独立生活能力、降低病人血浆IL-6及TNF-α水平有一定的促进作用,对促进脑梗死病人的康复具有一定的应用价值。

Objective To investigate the effect of centralized nursing intervention on the independent living capacity and the levels of interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in patients with cerebral infarction.Methods A total of 122 patients with cerebral infarction treated in Zhengzhou University Affiliated Luoyang Central Hospital from March 2016 to March 2017 were selected as the subjects and randomly assigned into the control group and the observation group,each with 61 cases.Two groups of patients were given antiplatelet therapy,improvement of brain circulation,nutrition of nerves,treatment of related complications and other conventional treatments.Patients in the control group were given routine care,while those in the observation group were given centralized nursing intervention.The independent living capacity,the levels of IL-6 and TNF-αof the two groups were observed and compared 3 months after nursing intervention.Results After intervention simplified Fugl-Meye motor recovery score and modified Barthel index(MBI)in the observation group were significantly higher than the control group[(63.57+12.53)points vs.(57.33±11.44)points,(83.07±9.21)points vs.(72.11±8.27)points,respectively;t/P=2.872/0.005,6.915/0.000,respectively].In the observation group,the levels of serum IL-6[(28.53+5.37)pg/mL]and TNF-α[(1.53+0.67)pg/mL]were significantly lower than those in the control group[IL-6:(37.34+4.84)pg/mL;TNF-α:(2.47+0.71)pg/mL],(t=9.518,7.520,respectively;both P=0.000).The total effective rate of the patients in the observation group was 91.80%,which was significantly higher than that in the control group(77.05%,χ^2=5.050,P=0.024).Conclusion Centralized nursing intervention can improve the motor function,independent living capacity and reduce the levels of plasma IL-6 and TNF-αin patients with cerebral infarction,which has certain application value in promoting the rehabilitation of patients with cerebral infarction.