初发脑卒中后认知功能障碍发生的相关因素分析及干预

Research on relative factors and nursing intervention for patients with cognitive disorder after initial onset of stroke

①目的探讨引发初发脑卒中后认知功能障碍发生的相关因素,观察综合性护理干预对改善患者认知功能的作用。②方法临床纳入初发脑卒中后患者174例,根据有无发生认知功能障碍分为认知障碍组与非认知障碍组,分析性别、年龄、病程、病变情况等与初发脑卒中后认知功能障碍的关系。将认知障碍组患者根据护理干预方式的不同分为研究组与对照组,研究组给予综合性护理干预,对照组给予常规护理干预,比较干预前后两组患者的认知功能情况。③结果患者的年龄、病程、病变部位、病灶大小、数量、卒中次数、有无高血压及糖尿病等基础疾病均是导致初发脑卒中后认知功能障碍发生的危险因素(P<0.05);干预前,两组蒙特利尔认知评估(MoCA)量表、Barthel指数及国立卫生研究院卒中(NIHSS)量表评分差异均无显著性(P>0.05)。干预后,研究组MoCA、NIHSS评分分别为25.03±1.45、2.91±1.40,对照组分别为21.74±1.60、4.18±1.59,差异均有显著性(P<0.05)。④结论患者年龄、病程、病变部位、病灶大小和数量、卒中次数、有无高血压、糖尿病等基础疾病均与初发脑卒中后认知功能障碍发生密切相关,而通过综合性护理干预,能够显著改善患者的认知功能,提高生存质量。

Objective:To study the relative factors for patients with cognitive disorder after the initial onset of stroke and observe the comprehensive nursing intervention on the improvement of the patient's cognitive function.Methods 174 patients with initial onset of stroke were selected.The subjects were divided into disorder group and normal group according to the incidence of cognitive disorder.The correlation of cognitive disorder with the patient's gender,age,course of disease,lesions was analyzed.In addition,the patients were divided into study group and control group according to different nursing methods;the study group adopted the comprehensive nursing intervention;the control group adopted the conventional nursing methods.The cognitive function for two groups was compared.Results The risk factors on the incidence of cognitive disorder included the patient's age,course of disease,diseased region,size and number of lesions,frequency of stroke and complications,etc(P<0.05);before intervention,the evaluation score of MoCA,Barthel index and NIHSS for two groups was not significantly different(P>0.05);after intervention,the evaluation score of MoCA and NIHSS for study group was 25.03±1.45 and 2.91±1.40;the score for control group was 21.74±1.60 and 4.18±1.59(P<0.05).Conclusion For patients with initial onset of stroke,the incidence of cognitive disorder has a close correlation with the patient's age,course of disease,diseased region,size and number of lesions,frequency of stroke and complications,etc.The comprehensive nursing intervention can greatly improve the patient's cognitive function and life quality.