临床护理路径对脑出血患者神经功能恢复及肢体功能改善的临床价值

Clinical value of clinical nursing pathway on recovery of nerve function and improvement of limb function in patients with intracranial hemorrhage

目的探讨临床护理路径对脑出血患者神经功能恢复及肢体功能改善的临床应用价值。方法前瞻性研究分析郑州市第九人民医院2015年1月至2021年2月共98例急性脑出血患者,入院急诊电子计算机断层扫描,确定治疗方案。随机将98例患者分为两组,每组49例。观察组男34例、女15例,年龄(56.4±16.3)岁;对照组男31例,女18例,年龄(59.4±15.4)岁。对照组入院后采用传统护理模式,观察组采用临床护理路径模式。入院后及出院前评估患者的美国国立卫生研究院卒中量表(NIHSS)评分、Barthel指数、护理满意度、汉密尔顿焦虑量表(HAMA)和Fugl-Meyer评估表(FMA评分),以评估不同治疗组中急性脑出血患者的神经功能、日常活动能力及不良情绪的改善情况。统计学方法采用χ^(2)检验、t检验。结果护理后,观察组的NIHSS评分和HAMA评分均低于对照组[(8.0±5.6)分比(10.6±3.3)分、(4.28±1.08)分比(5.76±0.92)分],差异均有统计学意义(t=2.82、7.30,均P<0.05)。观察组Barthel指数、FMA评分和护理满意度得分均高于对照组[(65.3±9.7)比(57.0±6.4)、(84.28±10.21)分比(75.18±11.12)分、(39.7±6.4)分比(30.5±5.2)分],差异均有统计学意义(t=5.02、4.12、5.24,均P<0.05)。结论临床护理路径的建立可显著改善急性脑出血患者的术后神经功能恢复,同时可缓解患者的不良心理情绪,增强患者的术后日常活动能力。

Objective To explore the clinical application value of clinical nursing pathway in restoring neurological function and improving limb function of patients with intracerebral hemorrhage.Methods A total of 98 patients with acute intracerebral hemorrhage in Zhengzhou Ninth people's Hospital from January 2015 to February 2021 were prospectively analyzed.The patients took emergent CT to decide the treatment scheme after admission.The patients were randomly divided into an observation group and a control group,with 49 in each group.There were 34 males and 15 females in the observation group;they were(56.4±16.3)years old.There were 31 males and 18 females in the observation group;they were(59.4±15.4)years old.The control group received the traditional nursing mode after admission,and the observation group the clinical nursing pathway mode.The National Institute of Health Stroke Scale(NIHSS),Barthel index,nursing satisfaction,Hamilton Anxiety Scale(HAMA),and Fugl-Meyer Assessment Scale(FMA)were used to evaluate the patients in both groups after admission and before discharge to evaluate their improvement of neurological function,daily activity ability,and adverse mood.χ^(2) and t tests were applied.Results The scores of NIHSS and HAMA in the observation group were lower than those in the control group[(8.0±5.6)vs.(10.6±3.3)and(4.28±1.08)vs.(5.76±0.92)],with statistical differences(t=2.82 and 7.30;both P<0.05).The scores of Barthel index,FMA,and nursing satisfaction in the observation group were higher than those in the control group[(65.3±9.7)vs.(57.0±6.4),(84.28±10.21)vs.(75.18±11.12),and(39.7±6.4)vs.(30.5±5.2)],with statistical differences(t=5.02,4.12,and 5.24;all P<0.05).Conclusion The establishment of clinical nursing pathway can significantly improve the postoperative neurological function recovery of patients with acute intracerebral hemorrhage,alleviate their adverse psychological mood,and enhance their ability of postoperative daily activities.