缺血性脑卒中患者疾病管理路径的建立与应用研究

Establishment and application of disease management pathway in patients with ischemic stroke

目的制订规范化的缺血性脑卒中疾病管理路径,评价其实用性与可靠性。方法采用非随机对照研究,通过便利抽样法将2019年1—8月新疆某三甲综合医院神经内科收治的112例患者分为两组,2019年1—5月的56例患者为对照组,进行常规护理;2019年6—8月的56例患者为干预组,进行疾病管理路径护理。分别评价两组美国国立卫生研究院卒中量表(NIHSS)、Barthel指数评定量表(BI)、满意度调查表得分情况。结果出院时两组NIHSS评分均低于入院时,且干预组NIHSS评分低于对照组(P<0.05);整体分析发现:组间比较、时间点比较及交互作用差异均有统计学意义(P<0.05)。进一步两两比较,组内比较:出院时、出院1、3、6个月的BI评分与入院时比较,差异有统计学意义(P<0.05);组间比较:干预组出院时、出院1、3、6个月的BI评分均高于对照组(P<0.05);干预组满意度评分高于对照组(P<0.05)。结论缺血性脑卒中疾病管理路径的建立与应用有效改善了患者肢体功能障碍,提升其日常生活活动能力与满意度。应用在临床护理中具有可行性与安全性。

Objective To develop a standardized management path for ischemic stroke and evaluate its practicability and reliability.Methods A non-randomized controlled study was conducted to divide 112 patients admitted to the Neurology Department of a Third-grade A general Hospital in Xinjiang from January to August 2019 into two groups by convenient sampling method.From January to June 2019,56 patients were treated as the control group and received routine nursing care.From June to August 2019,56 patients in the intervention group received disease management pathway care.The scores of national institutes of health stroke scale(NIHSS),barthel index rating scale(BI)and satisfaction survey were evaluated respectively in the two groups.Results NIHSS scores of both groups at discharge were lower than those at admission,and NIHSS scores of the intervention group were lower than those of the control group(P<0.05),overall analysis showed that the differences in intergroup comparison,time point comparison and interaction were statistically significant(P<0.05).Further pairwise comparison and intra-group comparison:the BI score at discharge,one,three and six months after discharge was statistically significant compared with that at admission(P<0.05).Comparison between groups:the BI scores of the intervention group at discharge,one,three and six months after discharge were all higher than those of the control group(P<0.05),satisfaction score of the intervention group was higher than that of the control group(P<0.05).Conclusion The establishment and application of the disease management pathway of ischemic stroke has effectively improved the limb dysfunction of patients and enhanced their daily activity ability and satisfaction with life.It has feasibility and safety in clinical nursing.