急性脑梗死静脉溶栓患者认知功能恢复的影响因素及康复护理策略

Influencing factors and rehabilitation nursing strategies of cognitive function recovery in patients with acute cerebral infarction combined with intravenous thrombolysis

目的探讨急性脑梗死静脉溶栓患者认知功能恢复影响因素及康复护理策略。方法回顾性分析2017年1月至2018年1月我院78例急性脑梗死静脉溶栓患者临床资料,于溶栓后3个月内统计认知功能恢复异常率;加强认知功能异常患者观察,采用多因素logistic回归分析影响认知功能相关因素;根据相关因素制定康复护理策略。结果认知功能恢复异常11例,异常率14. 10%。多因素logistic回归分析证实溶栓时间、梗死部位、NIHSS评分、代谢综合征是影响急性脑梗死静脉溶栓患者认知功能恢复的独立危险因素,早期认知功能康复训练是保护性因素(P <0. 05)。结论静脉溶栓能有效保护急性脑梗死患者认知功能,但溶栓时间、梗死部位、NIHSS评分、代谢综合征等因素能够影响急性脑梗死静脉溶栓后患者认知功能恢复。加强上述风险因素防控及早期采取认知功能康复护理,利于进一步保护急性脑梗死患者认知功能,改善预后。

Objective To investigate the influencing factors and rehabilitation nursing strategies of cognitive function recovery in patients with acute cerebral infarction combined with intravenous thrombolysis. Methods To analyze retrospectively the clinical data of 78 cases of patients with acute cerebral infarction combined with venous thrombolysis from January 2017 to January 2018 in our hospital. The abnormal rate of cognitive function recovery was counted within 3 months after thrombolysis,and the observation of patients with cognitive dysfunction was also Strengthened. Multi-factor logistic regression analysis was used to analyze the factors affecting cognitive function and rehabilitation nursing strategies were formulated based on the relevant factors. Results There were 11 cases of abnormal recovery of cognitive function,with an abnormal rate of 14. 10%. Multivariate logistic regression analysis showed that the thrombolytic time,infarct site,NIHSS score,and metabolic syndrome were independent risk factors that affected the recovery of cognitive function in patients with acute cerebral infarction combined with intravenous thrombolysis,and early cognitive function rehabilitation training was a protective factor( P <0. 05). Conclusion Intravenous thrombolysis could effectively protect the cognitive function of patients with acute cerebral infarction,but factors such as thrombolytic time,infarct site,NIHSS score,and metabolic syndrome could affect the recovery of cognitive function in patients with acute cerebral infarction. Strengthening the prevention and control of the above risk factors and early adopting cognitive function rehabilitation nursing would help to further protect the cognitive function and improve the prognosis of patients with acute cerebral infarction.