脑卒中后认知障碍患者早期认知康复护理的效果  

Effect of early cognitive rehabilitation nursing on patients with post-stroke cognitive impairment CHEN

作　　者：陈建伟[1] 韩立海[2] 张红梅[3] 薛燕[4] 高秀智[5] 周红丽[6] 

机构地区：[1]滨州医学院附属医院医院感染管理办公室,256603 [2]滨州医学院附属医院医院影像科,256603 [3]滨州医学院附属医院医院精神卫生中心,256603 [4]滨州医学院附属医院医院心血管内科,256603 [5]滨州医学院附属医院医院内科门诊,256603 [6]滨州医学院附属医院医院重症监护室,256603

出　　处：《中华现代护理杂志》2012年第30期3614-3617,共4页Chinese Journal of Modern Nursing

摘　　要：目的评价脑卒中后认知障碍（PSCI）的早期认知康复护理效果。方法选择60例初次确诊为缺血性脑卒中患者，随机分为观察组和对照组各30例，人院后均接受常规护理，观察组增加两周认知康复护理干预。分别在干预前、干预后采用功能独立性评定（FIM）和Zung氏抑郁自评量表（SDS）联合评估患者的身心状况、认知能力和独立生活能力。结果干预前两组的FIM和SDS量表各分项评分及总分组间差异均无统计学意义（P〉0．05），干预后观察组FIM中各分项评分及总分明显提高，差异均有统计学意义（P〈0．05），SDS中各症状组评分及总分显著降低，差异均有统计学意义（P〈0．01）；对照组干预后除运动、交流、社会认知和抑郁性心理障碍外，其他指标的评分及总分均优于干预前，差异均有统计学意义（P〈0．05）。干预后两组比较，观察组生活自理、括约肌控制、社会认知评分及总分（103．39±18．41）明显优于对照组（87．77±22．69），差异均有统计学意义（t／t’值分别为7．317，3．215，3．027，2．928；P均〈0．05），但转移、运动和交流方面的得分差异无统计学意义（t值分别为1．669，1．730，1．802；P均〉0．05）。结论早期认知康复护理能够促进脑卒中患者身心、认知功能康复，提高其独立生活能力，从而在很大程度上阻止PSCI的进展。Objective To evaluate the effect of early cognitive rehabilitation nursing on patients with post- stroke cognitive impairment. Methods Sixty patients who initially diagnosed as ischemic stroke were randomly divided into experimental group and control group. All of them received routine nursing after admission. In addition, the patients in the experimental group received cognitive rehabilitation nursing for two weeks. The patients were measured with Functional Independence Measure （FIM） and Self-Rating Depression Scale （SDS） before and after intervention to measure the condition of their body and psychology, cognition and independent living. Results There was no significant difference in the scores of FIM and SDS between the two groups before intervention （ P 〉 0.05 ）. However, after intervention, in the experimental group, all scores of FIM were significantly higher than before, and all scores of SDS were dramatically lower than before （P 〈 0.05）. In the control group, only some scores except those of movement, communication, social cognition and psychological symptoms in depression were significantly better than before （ P 〈 0. 05 ）. Compared with control group, the majority of scores of experimental group were significantly better than those of before intervention （P 〈 0.05 ）, but those of shift, movement and communication were no significant difference （ P 〉 0.05 ）. Conclusions Early cognitive rehabilitation nursing can improve stroke survivors recover in their condition of body and psychology, cognition and independent living, consequently prevent the progressing of PSCI in very great degree.

关 键 词：卒中 认知障碍 抑郁 康复护理 功能独立性评定 

分 类 号：R473.74[医药卫生—护理学]