辨证施护对急性脑梗死静脉溶栓患者生活质量的影响  

Effect of Dialectical Nursing on Qualities of Life in Patients with Acute Cerebral Infarction after Intravenous Thrombolysis

作　　者：苏曼莉[1] 童玲[1] 饶琴文[1] 刘晶晶[1] 戴旭辉[1] 吴辉[1] 

机构地区：[1]武汉市第一医院神经内科,湖北武汉430022

出　　处：《华南国防医学杂志》2017年第4期269-272,共4页Military Medical Journal of South China

基　　金：武汉市卫生和计划生育委员会临床医学科研基金项目(WZ15D17)

摘　　要：目的探讨辨证施护对急性脑梗死重组人组织纤维蛋白溶酶原激活剂(recombinant human tissue plasminogen activator,rt-PA)静脉溶栓患者生活质量的影响。方法选取采用阿替普酶静脉溶栓治疗急性脑梗死的患者为研究对象,根据随机数字表法分为观察组46例和对照组40例,观察组在常规护理的基础上实施辨证施护。在治疗前及治疗后7 d、30 d采用Barthel指数评估患者日常生活活动能力(activities of daily living,ADL)的改善情况,治疗后7d、90 d采用健康状况调查问卷(the short form-36 health survey,SF-36)评估患者的生活质量。结果两组患者治疗7d、30 d后Barthe指数均有提高,治疗7 d后组间比较差异无统计学意义(P>0.05);治疗30 d后观察组Barthel指数评分显著高于对照组,且差异具有统计学意义(P<0.05)。两组患者治疗7 d后SF-36评分比较差异无统计学意义(P>0.05);接受辨证施护90 d后SF-36评分,除了活力改善不明显以外,其他各方面观察组均明显高于对照组,组间比较差异有统计学意义(P<0.05)。结论对急性脑梗死静脉溶栓治疗患者实施辨证施护,可提高患者的ADL,改善生活质量。Objective To investigate the effects of dialectical nursing on the qualities of life in patients with acute cerebral infarction after thrombolytic therapy with alteplase. Methods The patients with acute cerebral infatretion were treated intravenous thrombolysis by alteplase, selected as the research object, and divided into observation group （n = 46） and control group （n = 40） according to the random number table. The observation group was applied on the basis of rou- tine nursing. The changes of activities of daily living （ADL） of patients before, after 7- and 90-day treatment were as- sessed by IMrthel index, and qualities of life after 7- and 90-day treatment were evaluated by short form-36 health survey （SF-36） scale. Results The Barthe indexes were increased in two groups after 7- and 90-day treatment, and there was no significantly difference after 7-day treatment （P〉0. 05）. The Barthel indexes in observation group after 30-day treatment was significantly higher than control group （P〈0. 05）. SF-36 scores in two groups after 7-day treatment were no significantly differences （P〉0. 05）. Except the activities were not obviously improved, SF-36 score of other aspects in observa- tion group after 90-day dialectical nursing were significantly higher than those in control group （P〈0. 05）. Conclusion Patients with acute cerebral infarction implement dialectical nursing with recombinant human tissue type plasminogen activator thrombolytic therapy. Dialectical nursing can improve ability of daily life, quality of life, achieve good prognosis. It is worthy of clinical application.

关 键 词：辨证施护 急性脑梗死 静脉溶栓 生活质量 

分 类 号：R471[医药卫生—护理学]