超早期康复护理对桥脑梗死患者心理、认知和生活质量的影响

Effects of super early rehabilitation nursing on mental state,cognitive function and quality of life in patients with pontine infarction

目的探讨超早期康复护理对桥脑梗死患者心理、认知和生活质量的影响。方法将2017年6月至2018年6月诊治的106例急性桥脑梗死患者纳入研究范围,按照随机数字表法分为对照组和观察组,每组53例。对照组实施常规护理干预,观察组实施超早期康复护理干预,观察2组护理前后心理状态、精神状态、睡眠质量、认知功能、生活质量及血清神经递质[脑源性神经营养因子(BDNF)、5-羟色胺(5-HT)、去甲肾上腺素(NE)]、免疫指标(CD4^+、CD8^+、CD4^+/CD8^+)变化。结果2组护理前HAMA评分、HAMD评分、MMSE评分、PSQI评分、MOCA评分、WMS评分、SF-36量表各维度评分、BDNF、5-HT、NE、CD4^+、CD8^+、CD4^+/CD8^+比较差异无统计学意义(P>0.05);与护理前比较,2组护理后HAMA评分、HAMD评分、MMSE评分、PSQI评分、CD8^+均明显降低,差异有统计学意义(P<0.05),MOCA评分、WMS评分、SF-36量表各维度评分、BDNF、5-HT、NE、CD4^+、CD4^+/CD8^+均明显升高,差异有统计学意义(P<0.05),且观察组以上指标变化程度更明显,差异有统计学意义(P<0.05)。结论对桥脑梗死患者实施超早期康复护理干预能够有效调节血清神经递质和免疫指标,从而改善患者心理、认知和生活质量,值得临床推广。

Objective To investigate the effects of super early rehabilitation nursing on mental state,cognitive function and life quality of patients with pontine infarction.Methods A total of 106 patients with pontine infarction who were treated in our hospital from Junuary 2017 to Junuary 2018 were enrolled in the study,who were randomly divided into observation group(n=53)and control group(n=53).The patients in control group were treated by conventional nursing intervention,however,the patients in observation group were treated by super early rehabilitation nursing intervention.The mental state,sleep state,cognitive function,quality of life and serum levels of neurotransmitter(BDNF,5-HT and NE)as well as the immune indexes(CD4^+,CD8^+and CD4^+/CD8^+)before and after nursing intervention were observed and compared between the two groups.Results Before nursing intervention,there were no significant differences in HAMA scores,HAMD scores,MMSE scores,PSQI scores,MOCA scores,WMS scores,SF-36 scores,and the levels of BDNF,5-HT,NE,CD4^+,CD8^+and CD4^+/CD8^+between the two groups(P>0.05).After nursing intervention,the HAMA scores,HAMD scores,MMSE scores,PSQI scores and CD8^+in both groups were significantly decreased,however,the MOCA scores,WMS scores,SF-36 scores,and the levels of BDNF,5-HT,NE,CD4^+and CD4^+/CD8^+in both groups were significantly increased(P<0.05).Moreover the above indexes in observation group were superior to those in control group(P<0.05).Conclusion The application of super early rehabilitation nursing intervention for the patients with pontine infarction can effectively regulate the serum neurotransmitters and immune indexes,so as to improve the mental state,cognitive function and life quality of patients,therefor,which is worthy of application and promotion in clinical practice.