以时间理念为基础的护理策略对颅内动脉瘤介入栓塞术患者术后效果的影响

Effect of nursing intervention based on the concept of time on postoperative rehabilitation in patients undergoing intravascular embolization for intracranial aneurysm

目的探讨以时间理念为基础的护理策略对颅内动脉瘤介入栓塞术患者术后肢体功能、自我护理能力及生活质量的影响。方法选取2014年12月至2017年12月间凤翔县医院收治的100例行介入栓塞术治疗的Hunt-Hess低分级颅内动脉瘤患者,采用随机数表法分为研究组和对照组,每组50例。对照组患者采用术后常规护理,研究组患者采用以时间理念为基础的护理干预。比较两组患者肢体运动功能(FMA)、生活自理能力、生活质量及脑缺血、脑血管痉挛等并发症的发生情况。结果干预后,研究组患者FMA各子项目评分及总分均高于对照组患者,差异均有统计学意义(均P <0. 05)。干预后,研究组患者自理能力评估量表(Barthel)指数分级优于对照组患者,Barthel指数平均值高于对照组患者,差异均有统计学意义(均P <0. 05)。干预后,研究组患者生活质量各子项目评分及总分均高于对照组患者,差异均有统计学意义(均P <0. 05)。研究组患者术后脑血管痉挛发生率低于对照组患者,差异有统计学意义(P <0. 05)。两组患者术后脑缺血发生率比较,差异无统计学意义(P> 0. 05)。结论基于时间理念的护理干预可促进Hunt-Hess低分级颅内动脉瘤介入栓塞术患者的术后康复,减少并发症发生。

Objective To investigate the effect of nursing strategy based on time concept on limb function,self-nursing ability and quality of life in patients with intracranial aneurysm after interventional embolization. Methods One hundred patients with Hunt-Hess low grade intracranial aneurysm undergoing intravascular embolization at Fengxiang County Hospital from December 2014 to December 2017 were selected as research subjects. They were divided into a study group and a control group by random number table method with 50 patients in each group. Patients in the study group underwent postoperative nursing intervention based on the concept of time and patients in the control group underwent postoperative routine nursing.Limb motor function fugel-meyer assessment( FMA) score was used to evaluate the limb motor function.Barthel index was used to evaluate the self-care ability. QLQ-c30 was used to evaluate the quality of life.The incidence of cerebral ischemia,cerebral vasospasm and other complications within 3 months after the surgery was compared between two groups. Results After the intervention,the overall score of FMA and each sub-item score of FMA score were higher in the study group than in the control group( all P < 0. 05).The average score of Barthel index was higher in the study group than in the control group( P < 0. 05). The overall score of quality of life and its each sub-item score were higher in the study group than in the control group( all P < 0. 05). The incidence of cerebrovascular spasm was lower in the study group than in the control group( P < 0. 05). There was no statistically significant difference in the incidence of postoperative cerebral ischemia between the two groups( P > 0. 05). Conclusion Nursing intervention based on the concept of time can promote postoperative rehabilitation and reduce postoperative complications in patients with Hunt-Hess low grade intracranial aneurysm undergoing intravascular embolization.