人性化干预管理联合进食体位指导在脑卒中患者中的应用效果
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摘要
目的探讨人性化干预管理联合进食体位指导在脑卒中患者中的应用效果。方法分析2015年1月~2018年1月大连市中心医院收治的200例脑卒中患者的临床资料,根据干预措施分为普通干预组(100例)和联合干预组(100例)。观察两组患者干预前后美国国立卫生研究院卒中量表(NIHSS)评分、改良Rankin量表(mRS)评分、日常生活活动能力(Barthel index)指数和上肢运动功能(Fugl-Meyer)评分情况,观察两组患者洼田饮水试验评级情况。结果两组患者干预前NIHSS评分、mRS评分、Barthel指数、Fugl-Meyer评分比较,差异无统计学意义(P> 0.05),干预后两组患者NIHSS评分、Barthel指数、Fugl-Meyer评分均高于同组干预前,m RS评分低于同组干预前,差异有统计学意义(P <0.05),且联合干预组患者干预后NIHSS评分、Barthel指数、Fugl-Meyer评分高于普通干预组,mRS评分低于普通干预组,联合干预组患者洼田饮水试验评级优于普通干预组,差异有统计学意义(P <0.05)。结论人性化干预管理联合进食体位指导在脑卒中患者中应用,可以改善患者神经功能、日常生活能力和运动功能,提高吞咽功能,值得临床推广应用。
Objective To approach effect of humanized intervention management combined with catering posture guidance in cerebral apoplexy patients. Methods From January 2015 to January 2018, in Dalian Municipal Central Hospital, the clinical data of 200 patients with cerebral apoplexy were analyzed, they were divided into general intervention group(100 cases) and joint intervention group(100 cases) by different intervention. The National Institute of Health Stroke scale(NIHSS) score, modified Rankin scale(mRS) score, Barthel index and Fugl-Meyer score of patients in two groups before and after intervention were detected, the Sumida drinking water test grade of patients in two groups were detected. Result The NIHSS score, mRS score, Barthel index and Fugl-Meyer score of patients in two groups before intervention were compared, the differences were no statistical significance(P > 0.05). The NIHSS scores, Barthel index and Fugl-Meyer scores in two groups were higher than before intervention, the mRS scores were lower than before intervention, the differences were statistically significant(P < 0.05); and the NIHSS scores, Barthel index and Fugl-Meyer scores of joint intervention group after intervention were higher than general intervention group, the mRS score was lower than general intervention group, the Sumida drinking water test grade in joint intervention group were better than general intervention group, the differences were statistically significant(P < 0.05). Conclusion The application of cerebral apoplexy patients by humanized intervention management combined with catering posture guidance, which could improve nerve function, Barthel and Fugl-Meyer, increase swallowing function, it is worth to be used.
Objective To approach effect of humanized intervention management combined with catering posture guidance in cerebral apoplexy patients. Methods From January 2015 to January 2018, in Dalian Municipal Central Hospital, the clinical data of 200 patients with cerebral apoplexy were analyzed, they were divided into general intervention group(100 cases) and joint intervention group(100 cases) by different intervention. The National Institute of Health Stroke scale(NIHSS) score, modified Rankin scale(mRS) score, Barthel index and Fugl-Meyer score of patients in two groups before and after intervention were detected, the Sumida drinking water test grade of patients in two groups were detected. Result The NIHSS score, mRS score, Barthel index and Fugl-Meyer score of patients in two groups before intervention were compared, the differences were no statistical significance(P > 0.05). The NIHSS scores, Barthel index and Fugl-Meyer scores in two groups were higher than before intervention, the mRS scores were lower than before intervention, the differences were statistically significant(P < 0.05); and the NIHSS scores, Barthel index and Fugl-Meyer scores of joint intervention group after intervention were higher than general intervention group, the mRS score was lower than general intervention group, the Sumida drinking water test grade in joint intervention group were better than general intervention group, the differences were statistically significant(P < 0.05). Conclusion The application of cerebral apoplexy patients by humanized intervention management combined with catering posture guidance, which could improve nerve function, Barthel and Fugl-Meyer, increase swallowing function, it is worth to be used.
引文
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[4]刘廷臻,张莉莉.脑卒中吞咽障碍患者进食体位依从性对误吸发生率的影响[J].中国农村卫生,2017,12(114):86.
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[10]梁艳桂,吴海科,谭峰,等.化痰通络汤联合舌咽针刺治疗脑梗死后假性球麻痹所致吞咽困难疗效观察[J].现代中西医结合杂志,2016,25(18):1974-1976.
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[12]全国脑血管病会议.各类脑血管疾病诊断要点[J].中华神经科杂志,1996,29(6):379-381.
[13]王新德.实用临床神经病学[M].北京:科学技术文献出版社,2007:619-620,630.
[14]应海丽,江崇凤,胡娇芬.集束化护理在脑卒中偏瘫患者良肢位摆放中的应用效果[J].实用临床医学,2017,18(10):74-75.
[15]杨晨晨,纪小凤,马海丽,等.进食体位对脑卒中后吞咽障碍患者相关并发症影响的Meta分析[J].护士进修杂志,2016,31(24):2223-2227.
[16]盛晗,邵圣文,王惠琴,等.脑卒中患者康复锻炼依从性动态变化的研究[J].中华护理杂志,2016,51(6):712-715.
[17]李婉玲,兰红珍,孔婵.Bobath技术在脑卒中后偏瘫患者体位转移中的应用[J].护理学报,2018,25(1):57-59.
[18]韩修英,闫文艳,杨海英,等.心理干预对脑卒中并发抑郁焦虑患者的干预效果及对治疗依从性的影响[J].中国老年学杂志,2016,36(2):412-414.
[19]宋东庆,李淑景,王玉春,等.早期康复治疗在ICU脑卒中患者康复中的疗效观察[J].中国临床医生杂志,2018,46(2):171-173.
[20]黄金英,周惠嫦.进食体位改变对脑卒中吞咽障碍病人误吸的研究[J].护理研究:中旬版,2013(29):3256-3257.
[2]Uchino K,Hernandez AV.Dabigatran association with higher risk of acute coronary events:meta-analysis of noninferiority randomized controlled trials[J].Arch Iternn Med,2012,172(5):397-402.
[3]黎桂婵,潘锋.脑卒中吞咽障碍患者进食体位依从性对误吸发生率的影响[J].齐鲁护理杂志,2016,22(17):96-97.
[4]刘廷臻,张莉莉.脑卒中吞咽障碍患者进食体位依从性对误吸发生率的影响[J].中国农村卫生,2017,12(114):86.
[5]中华医学会精神病学分会脑血管病组、神经康复学组.中国卒中康复治疗指南简化版[J].中华神经科杂志,2012,45(3):201.
[6]黄宏.理对脑卒中后吞咽障碍患者吞咽功能及营养状态的影响[J].国际护理学杂志,2014,33(10):2713.
[7]Zander U,Cianci M,Foos N,et al.Merging of synchrotron serial crystallographic data by a genetic algorithm[J].Acta Crystallogr D Struct Biol,2016,72(Pt9):1026-1035.
[8]蒋愈娇,文国强,黄莉.人性化干预管理联合进食体位指导预防脑卒中后吞咽障碍患者肺部感染的应用研究[J].中华医院感染学杂志,2018,28(19):3019-3022.
[9]刘廷臻,张莉莉.脑卒中吞咽障碍患者进食体位依从性对误吸发生率的影响[J].中国农村卫生,2017,12(114):86.
[10]梁艳桂,吴海科,谭峰,等.化痰通络汤联合舌咽针刺治疗脑梗死后假性球麻痹所致吞咽困难疗效观察[J].现代中西医结合杂志,2016,25(18):1974-1976.
[11]陈清棠.脑卒中患者临床神经功能缺损程度评分标准(1995)[J].中华神经科杂志,1996,29(6):381-383.
[12]全国脑血管病会议.各类脑血管疾病诊断要点[J].中华神经科杂志,1996,29(6):379-381.
[13]王新德.实用临床神经病学[M].北京:科学技术文献出版社,2007:619-620,630.
[14]应海丽,江崇凤,胡娇芬.集束化护理在脑卒中偏瘫患者良肢位摆放中的应用效果[J].实用临床医学,2017,18(10):74-75.
[15]杨晨晨,纪小凤,马海丽,等.进食体位对脑卒中后吞咽障碍患者相关并发症影响的Meta分析[J].护士进修杂志,2016,31(24):2223-2227.
[16]盛晗,邵圣文,王惠琴,等.脑卒中患者康复锻炼依从性动态变化的研究[J].中华护理杂志,2016,51(6):712-715.
[17]李婉玲,兰红珍,孔婵.Bobath技术在脑卒中后偏瘫患者体位转移中的应用[J].护理学报,2018,25(1):57-59.
[18]韩修英,闫文艳,杨海英,等.心理干预对脑卒中并发抑郁焦虑患者的干预效果及对治疗依从性的影响[J].中国老年学杂志,2016,36(2):412-414.
[19]宋东庆,李淑景,王玉春,等.早期康复治疗在ICU脑卒中患者康复中的疗效观察[J].中国临床医生杂志,2018,46(2):171-173.
[20]黄金英,周惠嫦.进食体位改变对脑卒中吞咽障碍病人误吸的研究[J].护理研究:中旬版,2013(29):3256-3257.