Clinical value of precise rehabilitation nursing in management of cerebral infarction

BACKGROUND Cerebral infarction,previously referred to as cerebral infarction or ischemic stroke,refers to the localized brain tissue experiencing ischemic necrosis or softening due to disorders in brain blood supply,ischemia,and hypoxia.The precision rehabilitation nursing model for chronic disease management is a continuous,fixed,orderly,and efficient nursing model aimed at standardizing the clinical nursing process,reducing the wastage of medical resources,and improving the quality of medical services.AIM To analyze the value of a precise rehabilitation nursing model for chronic disease management in patients with cerebral infarction.METHODS Patients(n=124)admitted to our hospital with cerebral infarction between November 2019 and November 2021 were enrolled as the study subjects.The random number table method was used to divide them into a conventional nursing intervention group(n=61)and a model nursing intervention group(n=63).Changes in the nursing index for the two groups were compared after conventional nursing intervention and precise rehabilitation intervention nursing for chronic disease management.RESULTS Compared with the conventional intervention group,the model intervention group had a shorter time to clinical symptom relief(P<0.05),lower Hamilton Anxiety Scale and Hamilton Depression Scale scores,a lower incidence of total complications(P<0.05),a higher disease knowledge mastery rate,higher safety and quality,and a higher overall nursing satisfaction rate(P<0.05).CONCLUSION The precision rehabilitation nursing model for chronic disease management improves the clinical symptoms of patients with cerebral infarction,reducing the incidence of total complications and improving the clinical outcome of patients,and is worthy of application in clinical practice.

Application Effect of Early Rehabilitation Nursing in Elderly Cerebral Infarction Patients with Dysphagia

Objective:To observe the application effect of early rehabilitation nursing in elderly cerebral infarction patients with dysphagia.Methods:120 cases of elderly cerebral infarction patients with dysphagia were divided into 60 cases in the control group and 60 cases in the observation group by the double-blind method,and conventional nursing and early rehabilitation nursing were implemented respectively.Swallowing function,quality of life,adverse events,and nursing satisfaction were compared before and after nursing care.Results:After nursing,the swallowing function score of the observation group(1.01±0.18 points)was lower than that of the control group,and the quality of life score(160.63±9.95 points)was higher than that of the control group(P<0.05);the incidence rates of aspiration and aspiration pneumonia in the observation group(5.00%and 3.33%)were lower than that of the control group(P<0.05);the total nursing satisfaction of the observation group(98.33%)was higher than that of the control group(P<0.05).Conclusion:Early rehabilitation nursing can reduce the degree of dysphagia in elderly patients with cerebral infarction,reduce the incidents of aspiration and aspiration pneumonia,and improve the quality of life,with high nursing satisfaction.

Application of a hospital–community–family trinity rehabilitation nursing model combined with motor imagery therapy in patients with cerebral infarction

BACKGROUND Rehabilitation nursing is considered an indispensable part of the cerebral infarction treatment system.The hospital–community–family trinity rehabilitation nursing model can provide continuous nursing services across hospitals,communities,and families for patients.AIM To explore the application of a hospital–community–family rehabilitation nursing model combined with motor imagery therapy in patients with cerebral infarction.METHODS From January 2021 to December 2021,88 patients with cerebral infarction were divided into a study(n=44)and a control(n=44)group using a simple random number table.The control group received routine nursing and motor imagery therapy.The study group was given hospital–community–family trinity rehabilitation nursing based on the control group.Motor function(FMA),balance ability(BBS),activities of daily living(BI),quality of life(SS-QOL),activation status of the contralateral primary sensorimotor cortical area to the affected side,and nursing satisfaction were evaluated before and after intervention in both groups.RESULTS Before intervention,FMA and BBS were similar(P>0.05).After 6 months’intervention,FMA and BBS were significantly higher in the study than in the control group(both P<0.05).Before intervention,BI and SS-QOL scores were not different between the study and control group(P>0.05).However,after 6months’intervention,BI and SS-QOL were higher in the study than in the control group(P<0.05).Before intervention,activation frequency and volume were similar between the study and the control group(P>0.05).After 6 months’intervention,the activation frequency and volume were higher in the study than in the control group(P<0.05).The reliability,empathy,reactivity,assurance,and tangibles scores for quality of nursing service were higher in the study than in the control group(P<0.05).CONCLUSION Combining a hospital–community–family trinity rehabilitation nursing model and motor imagery therapy enhances the motor function and balance ability of patients with cerebral infarction,improving their quality of life.

Nursing perspective of expert consensus on the diagnosis and treatment of cerebral infarction with integrated traditional Chinese and Western medicine

Cerebral infarction(CI)is also known as ischemic stroke.It is one of the most common cerebrovascular diseases,with high mortality and disability rate,which has seriously threatened human health.To better apply the diagnosis and treatment plan of integrated traditional Chinese and Western medicine to the treatment of patients with CI,the Chinese Association of Integrative Medicine issued the Expert Consensus on the Diagnosis and Treatment of Cerebral Infarction with the Integrated Traditional Chinese and Western Medicine in 2021.It involves etiology and pathogenesis of CI,diagnosis and treatment standards of Traditional Chinese Medicine(TCM)and Western Medicine,syndrome elements of TCM,as well as rehabilitation nursing of CI with integrated traditional Chinese and Western medicine during acute period and recovery period.This study interprets the consensus from routine nursing,dietary nursing,emotional nursing,complication nursing,rehabilitation nursing,and continuous nursing,aiming to provide evidence-based support for clinical TCM nursing practice.

Application of Evidence-based Nursing in Elderly Patients with Arrhythmia after Acute Myocardial Infarction

Objective: To investigate the effect of evidence-based nursing intervention in elderly patients with arrhythmia after acute myocardial infarction. Methods: 146 elderly patients with arrhythmia after acute myocardial infarction treated in our hospital from February 2016 to March 2017 were selected as research objects. According to the random number method, patients were divided into control group (73 cases, traditional nursing) and observation group (73 cases, evidence-based nursing intervention). The clinical effects and nursing satisfaction of the two groups were compared. Results: The hospital stay, average bed rest time, hospitalization cost, and incidence of arrhythmia complications in the observation group were significantly lower than those in the control group. The difference was statistically significant (P<0.05). After nursing, the four grades of heart function and satisfaction of nursing in the observation group were significantly higher than those in the control group. The difference was statistically significant (P<0.05). Conclusions: In elderly patients with arrhythmia after acute myocardial infarction, evidence-based nursing intervention was adopted. The patient's health has been greatly improved and the doctor-patient relationship has been significantly improved. This method is worth promoting.

以脑梗死为首发症状的卵巢癌患者围手术期护理

总结1例以脑梗死为首发症状的卵巢癌患者围手术期护理体会。针对患者病情危重复杂,围手术期易诱发血栓和出血,术后并发症风险增加,患者心理康复、肢体康复等问题,组建多学科合作团队全程管理;术前充分评估病情,制订护理计划;做好桥接抗凝期间用药护理;积极预防肺栓塞及新发脑梗死;采用中药灌肠法预防术后肠梗阻;鼓励家属参与患者心理护理,促进康复。通过积极治疗和护理,患者于术后第9天顺利出院。术后随访6个月,恢复良好。

基于赋能理论的延续性干预对脑梗死患者应对情况及心理状态的影响

目的探讨基于赋能理论的延续性干预对脑梗死患者应对情况及心理状态的影响。方法采用随机数字表法,将2021年7月至2022年3月在河北医科大学第二医院接受治疗的脑梗死患者112例分为对照组和观察组,每组56例。对照组给予常规护理,观察组在对照组的基础上,采用基于赋能理论的延续性干预,2组均干预6个月。比较2组干预后的治疗依从性及满意度,干预前后的医学应对方式问卷(MCMQ)、神经功能缺损量表(NIHSS)、日常生活活动能力(ADL)、脑卒中残损评定法量表(SIAS)、生活质量评分、心理状况[汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、心理弹性量表(CD-RISC)]。结果2组回避、屈服、NIHSS、HAMA、HAMD评分干预后较干预前降低,且观察组低于对照组(P<0.05);面对、ADL、SIAS、CD-RISC、生活质量各项评分升高,且观察组高于对照组(P<0.05);观察组的治疗总依从性高于对照组(P<0.05),观察组总满意度高于对照组(P<0.05)。结论基于赋能理论的延续性干预应用于脑梗死患者中,能够帮助调节患者的负性情绪,改善其神经功能,促进其身体功能恢复,提升生活质量、心理弹性恢复能力以及生活的自理能力,患者对其有较高的满意度,且能够提高患者面对疾病的信心,使其更加配合治疗。

基于目标导向的循序渐进式康复护理对脑梗死患者神经功能及生活质量的影响

目的探究基于目标导向的循序渐进式康复护理对脑梗死患者神经功能及生活质量的影响。方法收集我院2020年5月-2023年5月收治的120例脑梗死患者临床资料。按照护理方法的不同分为2组,观察组72例为实施基于目标导向的循序渐进式康复护理的患者,对照组48例为常规护理患者。比较患者恢复情况、神经功能、肢体功能、生活质量。结果观察组卧床时间(4.81±1.24)天、住院时间(9.58±2.25)天均低于对照组(5.45±1.31)天、(11.25±2.54)天,差异有统计学意义(P<0.05)。与干预前对照组相比,观察组神经功能缺损评分无显著变化(P>0.05),与干预后相比,两组神经功能缺损评分均显著降低,(t=20.136,P=0.000;t=14.680,P=0.000),且干预后的观察组评分(19.13±2.61)分低于对照组(21.44±2.82)分,差异有统计学意义(P<0.05)。与干预前对照组相比,观察组上肢、下肢功能评分无显著变化(P>0.05),与干预后相比,两组上肢、下肢功能评分均显著增加(t=43.599,P=0.000;t=23.703,P=0.000)、(t=29.546,P=0.000;t=15.362,P=0.000),且干预后的观察组评分高于对照组,差异显著(P<0.05)。与干预前对照组相比,观察组生活质量评分无显著变化(P>0.05),与干预后相比,两组生活质量评分均增加,差异显著(t=38.240,P=0.000;t=23.184,P=0.000),且干预后的观察组评分(68.78±3.85)分高于对照组(63.38±4.11)分,差异有统计学意义(P<0.05)。结论基于目标导向的循序渐进式康复护理能够改善脑梗死患者的神经功能缺损,提高生活质量,促进恢复。

1例心源性脑梗死后出血转化合并心肾综合征病人应用无创呼吸机治疗的护理

总结1例心源性脑梗死后出血转化合并心肾综合征病人应用无创呼吸机治疗的护理经验。护理要点:无创呼吸机辅助通气治疗的护理、液体及营养支持管理、静脉血栓的预防及处理、预防和控制感染、联合康复科制订渐进式康复方案、出院指导与随访。经过21 d的精心治疗和护理,病人病情稳定,顺利转回当地医院继续康复治疗。

基于莱温守恒模式的护理对急性脑梗死患者自我管理能力及神经功能的干预效果

目的探讨基于莱温守恒模式的护理干预对急性脑梗死患者自我管理能力及神经功能的影响。方法选择医院2021年3月—2022年6月收治的138例急性脑梗死患者,按照组间基线资料可比的原则分为对照组和观察组,各69例。对照组实施常规护理模式干预,观察组在对照组基础上采用基于莱温守恒模式的护理干预,干预6周。比较两组护理满意度、自我管理能力、神经功能[神经功能缺损评分表(NIHSS)]、肢体运动功能[运动功能评分量表(Fugl-Meyer)]及心理状态[焦虑自评量表(SAS)、抑郁自评量表(SDS)]。结果护理干预后,观察组患者护理满意率为92.75%,与对照组的79.71%对比,差异有统计学意义(P<0.05)。护理干预前,两组自我管理能力、神经功能、肢体运动功能及心理状态比较,差异无统计学意义(P>0.05);护理干预后,观察组自我管理能力各维度评分、肢体运动功能评分均高于对照组,差异有统计学意义(P<0.05);而观察组患者神经功能评价量表各项评分、SAS评分、SDS评分则低于对照组,差异有统计学意义(P<0.05)。结论基于莱温守恒模式的护理干预对急性脑横死患者效果更佳,可使患者负性情绪得到有效缓解,自我管理能力得到提高,还可有效改善患者神经功能,提高护理满意度。

优化溶栓护理流程联合超早期个性化护理对急性脑梗死溶栓患者康复效果及并发症的影响

目的探讨优化溶栓护理流程联合超早期个性化护理应用于急性脑梗死溶栓患者的临床效果。方法80例急性脑梗死溶栓患者随机分为两组,参照组予以常规护理,观察组予以优化溶栓护理流程联合超早期个性化护理干预,比较两组的康复效果和并发症。结果护理后,观察组的NIHSS评分低于参照组,Barthel评分高于参照组,并发症总发生率低于参照组(P<0.05)。结论优化溶栓护理流程联合超早期个性化护理可明显提高急性脑梗死溶栓患者的康复效果,降低并发症发生风险。

脑梗死后吞咽障碍患者护理中应用时间康复护理的效果探讨

目的探讨对脑梗死后吞咽障碍患者采用时间康复护理方式展开对应干预后获得的临床效果。方法回顾性选取2020年10月—2023年10月深圳市罗湖区人民医院收治的90例脑梗死后吞咽障碍患者的临床资料,依据不同护理方法分为参照组和研究组,每组45例。参照组采用常规护理方式展开疾病护理,研究组采用时间康复护理方式展开疾病护理,对比分析两组患者的护理总满意度、世界卫生组织生存质量测定量表简表(World Health Organization Quality of Life-BREF,WHOQOL-BREF)评分、洼田饮水试验评分。结果研究组护理总满意度高于参照组,差异有统计学意义(P<0.05);护理前,两组患者WHOQOL-BREF评分对比,差异无统计学意义(P>0.05);护理后,研究组环境因素评分、社会关系评分、生理因素评分、心理因素评分均高于参照组,差异有统计学意义(P均<0.05)。护理前,两组患者的洼田饮水试验评分比较,差异无统计学意义(P>0.05);护理后,研究组洼田饮水试验评分为(1.29±0.29)分低于参照组的(2.53±0.65)分,差异有统计学意义(t=11.687,P<0.05)。结论时间康复护理方式的合理运用,可显著提升脑梗死后吞咽障碍患者护理满意度、生存质量,有效改善吞咽功能。

综合康复护理干预对脑梗死合并2型糖尿病患者空腹血糖、餐后2 h血糖及生活质量的影响

目的探讨综合康复护理干预在脑梗死合并2型糖尿病患者中的实施效果。方法选取2020年1月—2023年1月寿光市人民医院收治的112例脑梗死合并2型糖尿病患者作为研究对象,运用双盲法将其随机均分为两组:参考组(n=56)和干预组(n=56),参考组开展常规护理,干预组开展综合康复护理干预,比较患者血糖指标、自护能力评分、生活质量评分、护理满意度组间差异。结果与参考组相比,干预组患者的血糖指标更优,自护能力、生活质量以及护理满意度的评分更高,差异有统计学意义(P均<0.05)。结论在脑梗死合并2型糖尿病患者的疾病护理中,综合康复护理干预的应用效果确切。

火龙罐综合灸联合耳穴压豆对肝肾亏虚型中风(脑梗死恢复期)后失眠患者的护理效果分析

目的 探讨火龙罐综合灸联合耳穴压豆对肝肾亏虚型中风(脑梗死恢复期)后失眠患者的护理效果。方法 随机选取2022年9月—2023年3月潍坊市中医院脑病康复科收治的30例肝肾亏虚型中风(脑梗死恢复期)后的失眠患者为研究对象,依据随机数表法分为观察组和对照组,每组15例。对照组采用耳穴压豆法护理干预,观察组采用火龙罐综合灸联合耳穴压豆法护理干预,比较两组患者护理后睡眠质量、生活质量及护理满意度。结果 护理后,观察组匹兹堡睡眠质量指数评分低于对照组,差异有统计学意义(P<0.05)。观察组脑卒中专门生活质量量表评分高于对照组,差异有统计学意义(P<0.05)。观察组护理满意度为93.33%,高于对照组,差异有统计学意义(P<0.05)。结论 火龙罐综合灸联合耳穴压豆可以提高患者的睡眠质量,提高生活质量。

循证护理在脑梗死患者护理中的应用效果分析

目的:分析循证护理在脑梗死患者护理中的应用效果。方法:选取临沂市郯城县第一人民医院2022年11月—2023年11月收治的90例脑梗死患者作为研究对象,通过盲选法随机分为对照组和观察组,各45例。对照组实施常规护理,观察组在对照组基础上实施循证护理。比较两组康复指标、神经功能、临床疗效、护理满意度。结果:观察组患者病情稳定所需时间、住院时间短于对照组(P<0.05)。护理前,两组患者神经功能评分比较,差异无统计学意义(P>0.05);护理后,两组患者神经功能评分低于护理前,且观察组低于对照组(P<0.05)。观察组患者治疗总有效率高于对照组(P=0.026)。观察组患者护理总满意度高于对照组(P=0.003)。结论:循证护理在脑梗死患者护理中的应用效果显著,可促进患者康复,改善患者神经功能,提高生活质量与护理满意度。

早期肢体功能训练护理在脑梗死患者中的应用效果及对改善患者生活质量的作用分析

目的 探究确诊脑梗死疾病患者的护理方案,主要分析早期肢体功能训练作用。方法 选取2021年1月-2023年1月60例脑梗死患者展开研究,根据护理方式分组,其中行常规护理的30例为对照组,行早期肢体功能训练的30例为观察组,对比两组效果。结果 观察组护理有效率高于对照组(P<0.05);观察组疾病指标优于对照组(P<0.05);观察组生活质量评分高于对照组(P<0.05)。结论 对确诊脑梗死患者实施早期肢体功能训练护理,可提升疗效,改善疾病指标和生活质量,值得临床推广。

急诊脑梗死病人溶栓后神经功能恶化风险预测模型的构建及验证

目的:构建急诊脑梗死病人溶栓后神经功能恶化风险预测模型,并进行效果检验。方法:采用便利抽样法,将2022年1月—2023年1月110例急诊脑梗死病人作为研究对象,按照溶栓后是否出现神经功能恶化分为恶化组与未恶化组,采用单因素分析、多因素Logistic回归分析筛选急诊脑梗死病人溶栓后神经功能恶化的相关危险因素,据此拟合风险预测模型的回归方程,检验模型预测效果。结果:急诊脑梗死病人溶栓后发生神经功能恶化共29例(26.36%);Logistic回归分析结果显示,溶栓前美国国立卫生院卒中量表评分、入院时收缩压、发病至溶栓时间、TOAST分型、血小板与淋巴细胞的比值(PLR)和血小板与中性粒细胞比值(PNR)为急性脑梗死病人溶栓后神经功能恶化的独立影响因素(P<0.05);预测模型Hosmer-Lemeshow检验结果显示,χ^(2)=6.941,P=0.297;C指数为0.838;受试者工作特征曲线下面积(AUC)值为0.814,95%CI(0.789,0.839),约登指数为0.683,最佳截断值为0.378,敏感度为93.5%,特异度为71.3%,模型预测准确率为81.81%。结论:在急诊脑梗死病人溶栓后神经功能恶化的危险因素基础上,建立的风险预测模型具有良好拟合程度和区分能力,且准确度较高,能为临床早期预防、早期筛选、早期治疗和管理神经功能恶化提供一定依据。

分级分区护理在急性脑梗死患者抢救中的应用效果分析

目的:分析分级分区护理在急性脑梗死患者抢救中的应用效果。方法:选取2020年6月—2021年6月徐州市中心医院抢救的120例急性脑梗死患者作为研究对象,随机分为观察组与对照组,各60例。对照组采用常规急诊护理模式,观察组采用分级分区护理模式。比较两组护理效果。结果:观察组候诊时间、抢救时间、住院时间短于对照组,抢救成功率高于对照组,差异有统计学意义(P<0.05)。护理前,两组上肢功能、下肢功能评分比较,差异无统计学意义(P>0.05);护理后,两组上肢功能、下肢功能评分高于护理前,且观察组高于对照组,差异有统计学意义(P<0.05)。观察组总依赖率低于对照组,差异有统计学意义(P<0.001)。结论:在急性脑梗死患者抢救过程中,采用分区分段护理可缩短候诊时间、抢救时间、出院时间,提升抢救成功率,改善患者肢体功能、自理功能。

时效性激励护理对脑梗塞患者负性情绪、创伤后成长和神经功能恢复的影响

目的:探讨时效性激励护理对脑梗塞患者负性情绪、创伤后成长和神经功能恢复的影响。方法:选取116例脑梗塞患者为研究对象,其中实施常规护理的58例设为对照组,实施时效性激励护理的58例设为观察组。两组均干预至患者出院,比较两组干预前后负性情绪[焦虑自评量标(SAS)和抑郁自评量表(SDS)]、创伤后成长[创伤后成长量表(PTGI)]、治疗依从性、神经功能情况[美国国立卫生院神经功能缺损评分表(NIHSS)]及主观幸福感[总体幸福感量表(GWB)]。结果:干预后,两组SAS及SDS评分均下降(P<0.05),且观察组低于对照组(P<0.05);两组PTGI量表总分及各维度评分均上升(P<0.05),且观察组高于对照组(P<0.05)。观察组治疗依从性优良率为94.83%,高于对照组的82.76%(P<0.05)。干预后,两组NIHSS评分均下降(P<0.05),且观察组低于对照组(P<0.05);两组GWB量表总分及各维度评分均上升(P<0.05),且观察组高于对照组(P<0.05)。结论:时效性激励护理可改善脑梗塞患者负性情绪,提高其创伤后成长及治疗依从性,进而有效改善脑梗塞患者神经功能缺损症状,提升其主观幸福感。

基于赋权—参与—合作理念的康复护理用于老年脑梗死患者的价值

目的研究基于赋权—参与—合作理念的康复护理用于老年脑梗死住院患者治疗中的价值,为治疗该病症提供方法。方法研究对象为2022年5月—2023年5月在四川大学华西医院治疗的320例老年脑梗死患者,以随机盲法分为观察组(n=160)和对照组(n=160)。对照组患者采用常规护理干预,观察组患者在对照组基础上加用基于赋权—参与—合作理念的康复护理,2组均干预2周。比较2组的预防跌倒行为、跌倒效能[采用修订版跌倒效能量表(MFES)评估]、日常生活能力[采用日常生活活动量表(ADL)评估]及康复信心[采用脑卒中后康复信心测量问卷中文版(CaSM)评估]。结果干预后,2组患者预防跌倒行为量表评分均高于同组干预前(P<0.05),而观察组患者预防跌倒行为量表评分高于对照组(P<0.05);2组患者跌倒效能量表中有充足的信心占比均高于同组干预前(P<0.05),而跌倒效能低下占比低于同组干预前(P<0.05),观察组有充足的信心占比高于对照组(P<0.05),观察组跌倒效能低下占比低于对照组(P<0.05);2组正常日常生活能力占比均高于同组干预前(P<0.05),且观察组正常日常生活能力占比高于对照组(P<0.05);2组患者CaSM评分均高于同组干预前(P<0.05),且观察组CaSM评分高于对照组(P<0.05)。结论采用基于赋权—参与—合作理念的康复护理可能改善老年脑梗死住院患者的预防跌倒行为,提高其跌倒效能、日常生活能力及康复信心,具有一定的临床应用价值。