首次脑梗死后VCI强化认知护理主导干预研究

Leadive Intervention Study of VCI Intensive Cognitive Care After First Cerebral Infarction

目的探讨首次脑梗死后存在血管性认知功能障碍(VCI)患者强化认知护理主导干预的效果。方法选取2015年1月—2018年9月间本院康复科收治的首次脑梗死后评估存在VCI患者40例,随机分为对照组和观察组各20例。对照组给予中西医药物通络治疗配合康复治疗和功能训练康复指导;观察组在对照组基础上配合实施护士主导下的强化认知训练干预措施。对比两组患者干预前和干预后6周及12周的神经功能缺损(NIHSS)、认知功能(MoCA)和日常生活活动能力(ADL)评估情况。结果干预前,两组NIHSS、MoCA和ADL评估指标比较无明显差异(P>0.05);干预6周,两组NIHSS均呈降低趋势,但差异不明显(P>0.05);干预12周,两组NIHSS降低趋势差异明显(P<0.05)。干预6周及12周,观察组NIHSS、MoCA和ADL评估指标明显优于对照组(P<0.05);干预12周,观察组MoCA和ADL评估指标显著优于对照组(P<0.05)。结论对首次脑梗死后VCI患者实施护士主导下的强化认知功能训练,能有效提高患者认知功能和日常生活活动能力,积极促进神经功能恢复。

Objective To investigate the effect of interventional intervention in patients with vascular cognitive dysfunction(VCI)after first cerebral infarction.Methods For the first time after cerebral infarction admitted to the hospital from January 2015 to September 2018,40 patients with VCI were randomly divided into control group and observation group.The control group was given the combination of Chinese and Western medicine for the treatment of rehabilitation and functional training.The observation group cooperated with the nurses to strengthen the cognitive training interventions.Neurological deficits(NIHSS),cognitive function(MoCA),and activities of daily living(ADL)were assessed before and 6 weeks and 12 weeks after intervention.Results Before the intervention,there was no significant difference between the two groups in the NIHSS,MoCA and ADL evaluation indexes(P>0.05).The intervention of 6 W,the NIHSS showed a decreasing trend,but the difference was not obvious(P>0.05);the intervention of 12 W,the two groups decreased the NIHSS The trend was significantly different(P<0.05).After intervention for 6 W,the evaluation indexes of MoCA and ADL in the observation group were significantly better than those in the control group(P<0.05).The intervention index of MoCA and ADL in the observation group was significantly better than that in the control group(P<0.05).Conclusion The implementation of nurse-led intensive cognitive function training in patients with VCI after the first cerebral infarction can effectively improve the cognitive function and activities of daily living,and actively promote the recovery of neurological function.