基于证据总结的目标康复训练对老年缺血性脑卒中后言语障碍患者功能恢复的影响

Effects of targeted rehabilitation training based on evidence summary on functional recovery of elderly patients with speech impairment after ischemic stroke

目的观察基于证据总结的目标康复训练对老年缺血性脑卒中后言语障碍患者功能恢复的影响。方法选取2020年1月-2023年6月安徽医科大学附属宿州医院全科医学科治疗的80例缺血性脑卒中后言语障碍患者,采用随机数字表法分为观察组和对照组,每组40例。对照组予以常规康复训练,观察组予以基于证据总结的目标康复训练。比较干预前后2组护士缺血性脑卒中后语言障碍患者目标康复训练知识得分、波士顿诊断性失语症检查量表(BDAE)评分、美国国立卫生研究院卒中量表(NIHSS)评分、汉密尔顿焦虑量表(HAMA)评分、汉密尔顿抑郁量表(HAMD)评分、改良Barthel指数(MBI)。结果(1)经2轮审查证据应用后,责任护士对A、B、C、D共4个阶段目标康复训练知识得分均高于应用前(P<0.05);(2)干预后,2组复述、理解、书写和阅读分值均高于同组干预前(P<0.05),且观察组复述、理解、书写和阅读分值均高于对照组(P<0.05);(3)干预后,2组NIHSS、HAMA及HAMD分值均明显低于同组干预前(P<0.05),且观察组的NIHSS、HAMA及HAMD评分均低于对照组(P<0.05);(4)干预后3个月、6个月,2组MBI分值均明显高于同组干预前(P<0.05),且观察组MBI分值高于对照组(P<0.05)。结论基于证据总结的目标康复训练应用于老年缺血性脑卒中后言语障碍患者,可改善患者语言功能、神经功能和生活质量,减少其不良情绪,明显提高护理管理质量,有一定的临床应用价值。

Objective To observe the effects of targeted rehabilitation training based on evidence summary on functional recovery of elderly patients with speech impairment after ischemic stroke.Methods 80 patients with speech impairment after ischemic stroke treated in Department of General Medicine of Suzhou Hospital Affiliated to Anhui Medical University from January 2020 to June 2023 were selected and divided into observation group and control group by random number table method,with 40 cases in each group.The control group received routine rehabilitation training,while the observation group received target rehabilitation training based on evidence summary.The score of nurses on target rehabilitation training knowledge for patients with speech impairment after ischemic stroke,and the scores of Boston Diagnostic Aphasia Examination(BDAE),National Institutes of Health Stroke Scale(NIHSS),Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD),and Modified Barthel Index(MBI)of the two groups of patients were compared before and after intervention.Results(1)After 2 rounds of evidence review,the scores of the responsible nurses on target rehabilitation training knowledge in stages A,B,C,and D were higher than before application(P<0.05).(2)After intervention,the scores of retelling,understanding,writing,and reading of both groups were higher than those of the same group before intervention(P<0.05),and the scores of the observation group were higher than those of the control group(P<0.05).(3)After intervention,the scores of NIHSS,HAMA and HAMD of both groups were significantly lower than those of the same group before intervention(P<0.05),and the scores of the observation group were lower than those of the control group(P<0.05).(4)After 3 and 6 months of intervention,the scores of MBI of both groups were significantly higher than those of the same group before intervention(P<0.05),and the scores of the observation group were higher than those of the control group(P<0.05).Conclusion The application of target rehabilitation training based on evidence summary to elderly patients with speech impairment after ischemic stroke can improve their language function,neurological function and quality of life,reduce their adverse emotions,and significantly improve the quality of nursing management,which has certain clinical application value.