急性脑卒中继发便秘患者对便秘症状、认知功能及日常生活能力的影响
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摘要
目的探讨针对性认知功能锻炼对急性脑卒中继发便秘患者便秘症状、认知功能及日常生活能力的影响。方法选取2016-07/2017-12在鄞州人民医院就诊的急性脑卒中继发便秘患者76例,参照随机数表法分为两组,各38例。对照组采用脑卒中及便秘的常规护理措施,观察组在对照组基础上予针对性认知功能锻炼,对比两组焦虑自评量表(self-rating anxiety scale, SAS)评分、抑郁自评量表(self-rating depression scale, SDS)评分、便秘症状积分、简易智力状态检查量表(minimental state examination, MMSE)评分、美国国立卫生研究院卒中量表(National Institute of health stroke scale, NIHSS)评分、Fugl-Meyer评定量表(Fugl-meyer assessment, FMA)评分、Barthel评分及护理满意度。结果观察组干预3 mo时SAS、SDS评分及便秘症状积分较显著低于对照组(P<0.05);干预3 mo时,观察组NIHSS评分显著低于对照组,而MMSE、FMA及Barthel评分均显著高于对照组(P<0.05);观察组护理满意度为100.00%(38/38),显著高于对照组的78.95%(30/38)(P<0.05)。结论针对性认知功能锻炼可有效减轻急性脑卒中继发便秘患者便秘症状,提高患者认知功能及日常生活能力,改善护患关系,值得进一步推广。
AIM To investigate the effect of targeted cognitive function exercise on constipation symptoms, cognitive function,and daily living ability in acute stroke patients with constipation.METHODS Seventy-six patients with constipation after acute stroke were enrolled at Yinzhou People's Hospital from July 2016 to December 2017 and randomly divided into either a control group or an observation group, with 38 cases in each group. Both groups were given routine nursing measures for stroke and constipation. The observation group was additionally given targeted cognitive function exercise. The two groups were compared for Self-rating Anxiety Scale(SAS) scores, Self-rating Depression Scale(SDS) scores, constipation symptom scores, Mini-Mental State Examination(MMSE) scores, National Institutes of Health Stroke Scale(NIHSS) scores, Fugl-Meyer Rating Scale(FMA) scores, Barthel scores, and nursing satisfaction. RESULTS The scores of SAS, SDS, and constipation symptoms at 3 mo after intervention were significantly lower in the observation group than in the control group(P < 0.05). NIHSS scores in the observation group were significantly lower than those in the control group at 3 mo, while MMSE, FMA, and Barthel scores in the observation group were significantly higher than those in the control group(P < 0.05). The satisfaction rate in the observation group was 100.00%(38/38), which was significantly higher than that in the control group [78.95%(30/38), P < 0.05]. CONCLUSION Targeted cognitive function exercise can effectively relieve constipation symptoms, increase cognitive function and daily living ability, and improve the relationship between nurses and patients in acute stroke patients with constipation.
AIM To investigate the effect of targeted cognitive function exercise on constipation symptoms, cognitive function,and daily living ability in acute stroke patients with constipation.METHODS Seventy-six patients with constipation after acute stroke were enrolled at Yinzhou People's Hospital from July 2016 to December 2017 and randomly divided into either a control group or an observation group, with 38 cases in each group. Both groups were given routine nursing measures for stroke and constipation. The observation group was additionally given targeted cognitive function exercise. The two groups were compared for Self-rating Anxiety Scale(SAS) scores, Self-rating Depression Scale(SDS) scores, constipation symptom scores, Mini-Mental State Examination(MMSE) scores, National Institutes of Health Stroke Scale(NIHSS) scores, Fugl-Meyer Rating Scale(FMA) scores, Barthel scores, and nursing satisfaction. RESULTS The scores of SAS, SDS, and constipation symptoms at 3 mo after intervention were significantly lower in the observation group than in the control group(P < 0.05). NIHSS scores in the observation group were significantly lower than those in the control group at 3 mo, while MMSE, FMA, and Barthel scores in the observation group were significantly higher than those in the control group(P < 0.05). The satisfaction rate in the observation group was 100.00%(38/38), which was significantly higher than that in the control group [78.95%(30/38), P < 0.05]. CONCLUSION Targeted cognitive function exercise can effectively relieve constipation symptoms, increase cognitive function and daily living ability, and improve the relationship between nurses and patients in acute stroke patients with constipation.
引文
1凌惠菊,颜雨虹,汪俐娜.穴位贴敷配合艾盐包热熨治疗急性脑卒中后便秘疗效观察.上海针灸杂志2017;36:1061-1064[DOI:10.13460/j.issn.1005-0957.2017.09.1061]
2赵红莉,杨海侠,卢清秀,孙妮,张红梅,姚婕.卯时综合护理干预对患者脑卒中后便秘的疗效观察.护理管理杂志2017;17:679-681[DOI:10.3969/j.issn.1671-315X.2017.09.025]
3Lim SF,Ong SY,Tan YL,Ng YS,Chan YH,Childs C.Incidence and predictors of new-onset constipation during acute hospitalisation after stroke.Int J Clin Pract 2015;69:422-428[PMID:25656963]
4马丽萍,杨春丽,仲桂英.认知行为干预对脑卒中便秘患者疗效的影响.中国老年学杂志2016;36:420-422[DOI:10.3969/j.issn.1005-9202.2016.02.079]
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7Moore SA,Hallsworth K,Jakovljevic DG,Blamire AM,He J,Ford GA,Rochester L,Trenell MI.Effects of Community Exercise Therapy on Metabolic,Brain,Physical,and Cognitive Function Following Stroke:A Randomized Controlled Pilot Trial.Neurorehabil Neural Repair 2015;29:623-635[PMID:25538152]
8王会民,杨松琪,张艳秋,邵义泽.中西医结合治疗缺血性脑卒中后胃肠功能障碍的临床研究.中华老年心脑血管病杂志2017;19:1320-1321[DOI:10.3969/j.issn.1009-0126.2017.12.024]
9Murray J,Doeltgen S,Miller M,Scholten I.A Descriptive Study of the Fluid Intake,Hydration,and Health Status of Rehabilitation Inpatients without Dysphagia Following Stroke.J Nutr Gerontol Geriatr 2015;34:292-304[PMID:26267442]
10李淑杏,杨芳,郝习君,陈长香.排便训练配合定时排便治疗脑卒中后便秘的效果.中国老年学杂志2015;35:1386-1387[DOI:10.3969/j.issn.1005-9202.2015.05.109]
11赵建军,许丽华.采用Wexner评分系统的综合护理在脑梗死患者便秘中的应用.中华现代护理杂志2017;23:4395-4397[DOI:10.3760/cma.j.issn.1674-2907.2017.34.022]
12Liu-Ambrose T,Eng JJ.Exercise training and recreational activities to promote executive functions in chronic stroke:a proof-of-concept study.J Stroke Cerebrovasc Dis 2015;24:130-137[PMID:25440324]
13王丽,周君桂,杨晓华,程代红,杨曼,王静新,蔡文智.脑卒中后便秘患者的认知行为干预研究.护理学杂志2014;29:39-42[DOI:10.3870/hlxzz.2014.03.039]
14张思为,周志,山林林,王玉龙.肝胃百合汤对脑卒中后肠内营养患者胃肠道并发症及神经功能评分的影响.河南中医2017;37:2120-2123[DOI:10.16367/j.issn.1003-5028.2017.12.0728]
15魏星.多方位护理干预在老年脑卒中患者便秘中的应用.国际护理学杂2017;36:1941-1944[DOI:10.3760/cma.j.issn.1673-4351.2017.14.021]
2赵红莉,杨海侠,卢清秀,孙妮,张红梅,姚婕.卯时综合护理干预对患者脑卒中后便秘的疗效观察.护理管理杂志2017;17:679-681[DOI:10.3969/j.issn.1671-315X.2017.09.025]
3Lim SF,Ong SY,Tan YL,Ng YS,Chan YH,Childs C.Incidence and predictors of new-onset constipation during acute hospitalisation after stroke.Int J Clin Pract 2015;69:422-428[PMID:25656963]
4马丽萍,杨春丽,仲桂英.认知行为干预对脑卒中便秘患者疗效的影响.中国老年学杂志2016;36:420-422[DOI:10.3969/j.issn.1005-9202.2016.02.079]
5Lin Y,Dong J,Yan T,He X,Zheng X,Liang H,Sui M.Involuntary,forced and voluntary exercises are equally capable of inducing hippocampal plasticity and the recovery of cognitive function after stroke.Neurol Res 2015;37:893-901[PMID:26179091]
6戚胜,董立焕,成杰,王云龙,刘萍萍,刘艳丰,王卫亮,张爱丽.脑卒中后急性应激障碍患者发生便秘的影响因素.中国健康心理学杂志2017;25:1335-1339[DOI:10.13342/j.cnki.cjhp.2017.09.016]
7Moore SA,Hallsworth K,Jakovljevic DG,Blamire AM,He J,Ford GA,Rochester L,Trenell MI.Effects of Community Exercise Therapy on Metabolic,Brain,Physical,and Cognitive Function Following Stroke:A Randomized Controlled Pilot Trial.Neurorehabil Neural Repair 2015;29:623-635[PMID:25538152]
8王会民,杨松琪,张艳秋,邵义泽.中西医结合治疗缺血性脑卒中后胃肠功能障碍的临床研究.中华老年心脑血管病杂志2017;19:1320-1321[DOI:10.3969/j.issn.1009-0126.2017.12.024]
9Murray J,Doeltgen S,Miller M,Scholten I.A Descriptive Study of the Fluid Intake,Hydration,and Health Status of Rehabilitation Inpatients without Dysphagia Following Stroke.J Nutr Gerontol Geriatr 2015;34:292-304[PMID:26267442]
10李淑杏,杨芳,郝习君,陈长香.排便训练配合定时排便治疗脑卒中后便秘的效果.中国老年学杂志2015;35:1386-1387[DOI:10.3969/j.issn.1005-9202.2015.05.109]
11赵建军,许丽华.采用Wexner评分系统的综合护理在脑梗死患者便秘中的应用.中华现代护理杂志2017;23:4395-4397[DOI:10.3760/cma.j.issn.1674-2907.2017.34.022]
12Liu-Ambrose T,Eng JJ.Exercise training and recreational activities to promote executive functions in chronic stroke:a proof-of-concept study.J Stroke Cerebrovasc Dis 2015;24:130-137[PMID:25440324]
13王丽,周君桂,杨晓华,程代红,杨曼,王静新,蔡文智.脑卒中后便秘患者的认知行为干预研究.护理学杂志2014;29:39-42[DOI:10.3870/hlxzz.2014.03.039]
14张思为,周志,山林林,王玉龙.肝胃百合汤对脑卒中后肠内营养患者胃肠道并发症及神经功能评分的影响.河南中医2017;37:2120-2123[DOI:10.16367/j.issn.1003-5028.2017.12.0728]
15魏星.多方位护理干预在老年脑卒中患者便秘中的应用.国际护理学杂2017;36:1941-1944[DOI:10.3760/cma.j.issn.1673-4351.2017.14.021]