急性缺血性脑卒中患者中医延续性护理方案的构建与应用研究

doi:10.3761/j.issn.0254-1769.2021.08.001

摘要/Abstract

摘要：

目的构建中医延续性护理方案并评价其在急性缺血性脑卒中出院患者中的应用效果。方法采用便利抽样法,选取2019年6月—2020年6月在广西壮族自治区某三级甲等医院脑病科住院的急性缺血性脑卒中患者102例作为研究对象,随机分为试验组（n=51）和对照组（n=51）。试验组在常规护理的基础上实施中医延续性护理方案,对照组实施常规护理。两组于出院时,出院后1个月、2个月和3个月,分别采用简式Fugl-Meyer运动功能评估量表（Fugl-Meyer Assessment,FMA）、脑卒中专门化生活质量表（Stroke specific quality of life scale,SS-QOL）进行评估。结果出院时,试验组FMA评分、SS-QOL评分与对照组相比,差异无统计学意义（P>0.05）;出院后1个月,试验组FMA评分与对照组相比,差异无统计学意义（P>0.05）,SS-QOL评分试验组高于对照组（P<0.05）;出院后2个月和3个月,试验组FMA评分、SS-QOL评分均显著高于对照组（P<0.05）;重复测量方差分析显示,组间、时间、组间与时间的交互作用对FMA评分、SS-QOL评分的影响具有统计学意义（P<0.05）。结论该研究构建的中医延续性护理方案具有一定的科学性和可行性,可有效改善急性缺血性脑卒中患者的肢体运动功能,提高其生活质量。

关键词: 脑卒中, 延续护理方案, 清单式管理, 中医护理

Abstract:

Objective To construct a traditional Chinese medicine（TCM） continuous care program and to evaluate its application effect in discharged patients with acute ischemic stroke. Methods A total of 102 patients with acute ischemic stroke hospitalized in the Department of Encephalopathy of a tertiary hospital in Guangxi from June 2019 to June 2020 were selected as the research subjects by convenience sampling method. They were randomly allocated into an experimental group（n=51） and a control group（n=51）.The experimental group was carried out with the TCM continuous care program on the basis of routine nursing,while the control group received the routine nursing. At the time of discharge and 1 month,2 months and 3 months after discharge,the 2 groups of patients were investigated and evaluated by a simple Fugl-Meyer Assessment Scale（FMA） and Stroke Specific Quality of Life Scale（SS-QOL）. Results There was no significant difference in FMA score and SS-QOL score between the experimental group and the control group at the time of discharge（P>0.05）. A month after discharge,there was no significant difference in the FMA score between the experimental group and the control group（P>0.05）,but the SS-QOL score in the experimental group was higher than that in the control group（P<0.05）.The scores of FMA and SS-QOL in experimental group were significantly higher than those in the control group at 2 and 3 months after discharge（P<0.05）. 3 months after discharge,the clinical efficacy of the experimental group was significantly better than that of the control group（P<0.05）. The analysis of variance of repeated measurement data showed that the interaction between groups,time,and inter-groups and time had statistically significant effects on FMA score and SS-QOL score（P<0.05）. Conclusion The constructed TCM continuous care program is scientific and feasible,which can effectively improve the limb motor function of patients with acute ischemic stroke and improve their quality of life at home.

Key words: Stroke, Continuing Care Program, Inventory Management, Traditional Chinese Medicine Nursing Care

金婕,钟美容,于秀婷,杨甜甜,范葵钰,黄小洁. 急性缺血性脑卒中患者中医延续性护理方案的构建与应用研究[J]. 中华护理杂志, 2021, 56(8): 1125-1132.

JIN Jie,ZHONG Meirong,YU Xiuting,YANG Tiantian,FAN Kuiyu,HUANG Xiaojie. Construction and application of a traditional Chinese medicine continuing care program for patients with acute ischemic stroke[J]. Chinese Journal of Nursing, 2021, 56(8): 1125-1132.

图/表 3

图1 急性缺血性脑卒中中医延续护理方案

Figure 1 TCM continued nursing program for acute ischemic stroke

表1 两组一般资料比较[例（百分比,%)]

Table 1 Comparison of general data in the 2 groups[cases（percentage,%）]

表2 两组出院前后Fugl-Meyer运动功能评分、脑卒中专门化生活质量评分比较（分,$\bar{x}$±s）

Table 2 Comparison of Fugl-Meyer motor function scores and stroke specialized quality of life scores between the two groups before and after discharge（points,$\bar{x}$±s）

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