临床优化路径护理方案在急性脑梗死静脉溶栓患者中的应用价值

Clinical Value of Optimized Pathway Nursing in Patients with Acute Cerebral Infarction with Intravenous Thrombolysis

目的 探讨临床优化路径护理方案在急性脑梗死静脉溶栓患者中的应用价值。方法 选取2021年4月至2022年10月扬州大学附属医院收治的80例急性脑梗死行静脉溶栓患者作为研究对象,随机分为对照组和观察组,每组40例,对照组采用常规护理方案,观察组采用临床优化路径护理方案。比较两组患者血管再通及术后并发症发生率、运动神经功能以及自我效能。结果 干预后,观察组血管再通发生率明显高于对照组,吞咽功能障碍、肺炎发生率显著低于对照组,差异有统计学意义(P<0.05);干预前,两组美国国立卫生研究院卒中量表(NIHSS)、Barthel指数(BI)、Fugl-Meyer评分比较差异无统计学意义(P>0.05);干预后,观察组NIHSS评分明显低于对照组,BI、Fugl-Meyer评分明显高于对照组,差异有统计学意义(P<0.05);干预后观察组完成自我管理、一般自我效能、达成效果、应对问题评分明显高于对照组(P<0.05)。结论 临床优化路径护理方案有利于提高急性脑梗死静脉溶栓患者的血管再通率,降低术后并发症发生率,改善运动神经功能,从而提高患者的自我效能。

Objective To explore the application value of clinical optimized pathway nursing in patients with acute cerebral infarction with intravenous thrombolysis.Methods Eighty patients with acute cerebral infarction who received intravenous thrombolysis from the Affiliated Hospital of Yangzhou University from April 2021 to October 2022 were selected as the study objects and randomly divided into control group and observation group,with 40 cases in each group.The control group was treated with routine nursing plan,and the observation group was treated with clinical optimization pathway nursing plan.The incidence of vascular recanalization and postoperative complications,motor function and self-efficacy were compared between the two groups.Results After intervention,the incidence of vascular recanalization in the observation group was significantly higher than that in the control group,and the incidence of swallowing dysfunction and pneumonia was significantly lower than that in the control group,with statistical significance(P<0.05).Before intervention,there were no significant differences in the National Institutes of Health Stroke Scale(NIHSS),Barthel Index(BI)and Fugl-Meyer score between the two groups(P>0.05).After intervention,NIHSS score of observation group was significantly lower than control group,BI and Fugl-Meyer score were significantly higher than control group,the difference was statistically significant(P<0.05).After intervention,the scores of self-management,general self-efficacy,achievement effect and coping problems in the observation group were significantly higher than those in the control group(P<0.05).Conclusion Clinical optimal pathway nursing scheme is beneficial to improve the rate of vascular revascularization,reduce the incidence of postoperative complications,improve the motor function and the self-efficacy of patients with acute cerebral infarction.