持续护理临床路径对缺血性脑卒中患者康复效果的影响

Clinical Value of Continuous Clinical Nursing Pathway to Rehabilitation of Patient with Ischemia Stroke

目的探讨持续护理临床路径对缺血性脑卒中患者康复效果的影响,以期为缺血性脑卒中标准化护理提供数据支持。方法选取2018年1月至2018年12月于昌图县中心医院内科进行治疗的符合缺血性脑卒中诊断及纳入标准的105例患者,按照入院时间顺序排序后将其分为对照组(50例)和观察组(55例)。对照组采用常规护理,观察组采用持续护理临床路径,按时间节点严格开展健康宣教、康复指导、功能训练及心理疏导等,分别于出院当日、出院后1个月及出院后3个月采用汉密尔顿焦虑量表(HAMA)、Fugl-Meyer运动功能评分量表(FMA)评估两组患者的恢复情况。结果干预后,观察组治疗总有效率高于对照组,差异有统计学意义(P <0.05)。出院当日、出院后1个月及出院后3个月,观察组HAMA、FMA评分均优于对照组,差异均有统计学意义(均P <0.05);观察组护理满意度高于对照组,差异有统计学意义(P <0.05);出院后3个月,观察组复发率为3.64%,对照组为18.00%,差异有统计学意义(P <0.05)。结论采用持续护理临床路径干预缺血性脑卒中患者,可促进患者功能的快速恢复,并改善负性心理,患者的临床满意度较高。从中长期来看,该法可有效节约医疗资源,降低家庭经济负担,改善患者生活质量。

Objective To explore the impact of continuous nursing care on the rehabilitation effect of patients with ischemic stroke,in order to provide data support for standardized care of ischemic stroke.Methods Select 105 patients who met the ischemic stroke diagnosis and inclusion criteria and were treated in the Department of Internal Medicine of the Central Hospital of Changtu from January 2018 to December 2018.They were sorted according to the order of admission time and divided into the control group(50 cases)and observation group(55 cases).The control group adopts routine nursing care,and the observation group adopts the clinical path of continuous nursing,and strictly carries out health education,rehabilitation guidance,functional training and psychological counseling according to the time node.Hamlton Anxiety Scale(HAMA)and Fugl-Meyer Motor Function Rating Scale(FMA)evaluated the recovery of the two groups of patients on the day of discharge,1 month after discharge and 3 months after discharge.Results After intervention,the total eff ective rate of treatment in the observation group was higher than that in the control group,and the difference was statistically signifi cant(P<0.05).On the day of discharge,1 month after discharge,and 3 months after discharge,the HAMA and FMA scores of the observation group were better than those of the control group,and the differences were statistically signifi cant(all P<0.05);the nursing satisfaction of the observation group was higher than that of the control group,and the diff erence was statistically signifi cant(P<0.05);3 months after discharge,the recurrence rate was 3.64%in the observation group and 18.00%in the control group,and the difference was statistically signifi cant(P<0.05).Conclusion Intervening patients with ischemic stroke through the clinical pathway of continuous care can promote the rapid recovery of patients'functions and improve negative psychology.The patients'clinical satisfaction is higher.In the medium and long term,it can effectively save medical resources and reduce the financial burden of the family,improve the quality of life of patients.