双主体三步法对脑血管动脉瘤介入治疗患者康复进度、急性应激障碍及功能康复的影响

Effect of two-subject three-step method on rehabilitation progress,acute stress disorder,and functional rehabilitation of patients with cerebrovascular aneurysm undergoing interventional therapy

目的探究双主体三步法对脑血管动脉瘤介入治疗患者康复进度、急性应激障碍及功能康复的影响。方法选取2021年6月至2023年6月郑州大学第一附属医院收治的244例脑血管动脉瘤患者作为研究对象,按随机数表法分为对照组和观察组各122例,对照组患者给予常规护理,观察组患者于此基础上给予双主体三步法护理模式,干预至出院后3个月。比较两组患者的康复进度,以及干预前后的急性应激障碍量表(ASDS)评分、医学应对方式问卷(MCMQ)评分、Fugl-Meyer运动功能测评法(FMA)评分和改良Barthel指数(BI)。结果观察组患者术后清醒时间、尿管留置时间、住院时间分别为(11.32±1.85)h、(7.20±0.68)d、(18.36±3.18)d,明显短于对照组的(24.35±2.36)h、(11.75±0.83)d、(20.14±3.76)d,差异均有统计学意义(P<0.05);干预后,观察组患者ASDS量表中分离症状、再体验症状、高警觉症状、回避症状评分分别为(7.10±1.10)分、(6.56±0.96)分、(11.03±1.69)分、(5.32±0.67)分,明显低于对照组的(8.32±1.27)分、(8.24±1.12)分、(13.14±1.13)分、(7.56±1.18)分,差异均有统计学意义(P<0.05);干预后,观察组患者MCMQ量表中回避、面对、屈服评分分别为(11.24±2.36)分、(26.06±3.17)分、(8.32±1.38)分,明显低于对照组的(16.36±3.22)分、(20.53±4.14)分、(10.29±2.15)分,差异均有统计学意义(P<0.05);干预后,观察组患者FMA、BI评分分别为(70.69±5.10)分、(81.02±5.24)分,明显低于对照组的(64.59±44.32)分、(76.33±4.69)分,差异均有统计学意义(P<0.05)。结论双主体三步法应用于脑血管动脉瘤患者的管理,可减轻患者急性应激障碍,改善其应对方式,加速术后康复进度,提高肢体运动及日常生活能力。

Objective To explore the effects of two-subject three-step method on the rehabilitation progress,acute stress disorder,and functional rehabilitation of patients with cerebrovascular aneurysm undergoing interventional therapy.Methods A total of 244 patients with cerebrovascular aneurysm admitted to the First Affiliated Hospital of Zhengzhou University from June 2021 to June 2023 were selected and randomly divided into a control group and an observation group according to the random number table method,each with 122 patients.The patients in the control group were given routine care,while the patients in the observation group were given a two-subject three-step nursing model based on routine care,until three months after discharge.The rehabilitation progress of the two groups of patients was compared,as well as the scores of the Acute Stress Disorder Scale(ASDS),the Medical Coping Modes Questionnaire(MCMQ),the Fugl-Meyer Assessment of Motor Function(FMA),and the Modified Barthel Index(BI)before and after intervention.Results In the observation group,the postoperative waking time,urinary catheter retention time,and length of hospital stay were(11.32±1.85)h,(7.20±0.68)d,and(18.36±3.18)d,respectively,significantly shorter than(24.35±2.36)h,(11.75±0.83)d,(20.14±3.76)d in the control group(P<0.05).After intervention,the scores of dissociation symptom,reexperience symptom,hypervigilance symptom,and avoidance symptom in the observation group were(7.10±1.10)points,(6.56±0.96)points,(11.03±1.69)points,(5.32±0.67)points,respectively,significantly lower than(8.32±1.27)points,(8.24±1.12)points,(13.14±1.13)points,(7.56±1.18)points in the control group(P<0.05).After intervention,the avoidance,facing,and yield scores in MCMQ scale of patients in the observation group were(11.24±2.36)points,(26.06±3.17)points,and(8.32±1.38)points,which were significantly lower than(16.36±3.22)points,(20.53±4.14)points,and(10.29±2.15)points in the control group(P<0.05).After intervention,the FMA and BI scores of the observation group were(70.69±5.10)points and(81.02±5.24)points,respectively,which were significantly lower than(64.59±44.32)points and(76.33±4.69)points of the control group(P<0.05).Conclusion The application of two-subject three-step method in the management of patients with cerebrovascular aneurysms can alleviate acute stress disorder,improve their coping style,accelerate the progress of postoperative rehabilitation,and improve the ability of limb movement and daily life.