基于奥马哈理念干预模式对脑出血老年患者神经功能及日常生活能力的影响

Study on the influence of intervention mode based on Omaha concept on neurological function and ADL level of elderly patients with cerebral hemorrhage

目的探讨基于奥马哈理念干预模式对脑出血老年患者神经功能及ADL水平的影响。方法回顾性分析2019-10—2020-09郑州大学第一附属医院收治110例脑出血老年患者,根据护理方式的不同分为2组,对照组(55例)给予常规护理,观察组(55例)给予奥马哈理念干预。基于Holden步行能力(FAC)、Berg平衡量表(BBS)、改良Barthel指数(MBI)评定干预前后2组日常生活能力(ADL)评分;基于S100β蛋白(S100β)、神经元特异性烯醇化酶(NSE)对比2组干预前后神经功能水平;基于生活质量评定量表(SF-36)对比2组干预前后生活质量,包括心理角色、心理功能、躯体功能。结果2组FAC等各项ADL评分干预前无显著差异(P>0.05),观察组FAC等各项ADL评分干预后分别为3.54±1.02、40.28±3.87、71.45±6.18,优于对照组(2.23±0.76、27.36±3.19、58.64±5.34),组间比较差异均有统计学意义(P<0.05)。2组NSE等神经功能水平干预前无显著差异(P>0.05),观察组NSE水平等神经功能干预后分别为(0.86±0.13)ng/mL、(18.11±2.35)ng/mL,低于对照组的(1.05±0.21)ng/mL、(22.25±4.07)ng/mL,组间比较差异有统计学意义(P<0.05)。2组躯体功能等干预前评分无显著差异(P>0.05),观察组躯体功能等评分干预后为86.37±5.63、78.41±4.52、84.74±5.45,高于对照组(65.68±4.02、54.33±3.45、68.27±4.56),差异均有统计学意义(P<0.05)。结论基于奥马哈理念干预模式能够提升脑出血老年患者的神经功能,同时改善其生活质量。

Objective To study and explore the effect of intervention mode based on Omaha concept on neurological function and ADL level of elderly patients with cerebral hemorrhage.Methods Totally 110 elderly patients with cerebral hemorrhage in our hos⁃pital from October 2019 to September 2020 were retrospectively analyzed.They were divided into control group(55 cases)and observa⁃tion group(55 cases)according to different nursing schemes.The control group was given routine nursing mode,and the observation group was given Omaha concept intervention mode.Based on Holden walking ability(FAC),Berg Balance Scale(BBS)and modified Barthel Index(MBI),the ADL scores of the two groups before and after the intervention were evaluated.Based on S100βprotein(S100β),neuron specific enolase(NSE)and other indicators,the neurological function levels of the two groups before and after intervention were compared.Based on the quality of life assessment scale(SF-36),the changes of psychological role,psychological function and physical function were compared between the two groups before and after the intervention.Results before the intervention,there was no difference in ADL scores between the two groups(P>0.05).After the intervention,the ADL scores of the observation group were(3.54±1.02,40.28±3.87 and 71.45±6.18),which were better than those of the control group(2.23±0.76,27.36±3.19 and 58.64±5.34),and there were differences between the two groups(P<0.05).Before intervention,there was no difference in S100βand NSE levels between the two groups(P>0.05).After intervention,S100βand NSE levels in the observation group were((0.86±0.13)ng/mL,(18.11±2.35)ng/mL),which were lower than those in the control group((1.05±0.21)ng/mL,(22.25±4.07)ng/mL),and there was difference between the two groups(P<0.05).Before the intervention,there was no difference in the scores of physical function between the two groups(P>0.05).After the intervention,the scores of physical function in the observation group were(86.37±5.63,78.41±4.52,84.74±5.45),which were higher than those in the control group(65.68±4.02,54.33±3.45,68.27±4.56),and there were differences between the two groups(P<0.05).Conclusion For elderly patients with cerebral hemorrhage,Omaha concept intervention model can effectively im⁃prove the level of ADL and neurological function,improve the quality of life of patients.