脑梗死后认知功能障碍影响因素及认知护理干预  

Influencing factors of cognitive dysfunction after cerebral infarction and cognitive nursing intervention

作　　者：祝刚[1] 李爱华 杨沙[1] ZHU Gang;LI Ai-hua;YANG Sha(Department of Neurology, Xiaogan Central Hospital, Xiaogan 432000, Hubei, CHINA;Xiaogan Huangmailing Hospital, Xiaogan 432000, Hubei, CHINA)

机构地区：[1]孝感市中心医院神经内科,湖北孝感432000 [2]孝感市黄麦岭医院,湖北孝感432000

出　　处：《海南医学》2019年第7期942-945,共4页Hainan Medical Journal

摘　　要：目的分析脑梗死后发生认知功能障碍的危险因素,并探讨认知护理干预的应用价值。方法选择孝感市中心医院神经内科于2017年1月至2018年2月收治的脑梗死患者92例,入院时使用蒙特利尔认知评估量表(MoCA)进行认知功能评价,分析脑梗死后认知功能障碍的危险因素,并针对相关危险因素给予认知护理干预,2周后使用自制调查表调查患者对护理的满意度。结果经MoCA评价,结果显示92例脑梗死患者中30例有认知功能障碍,占32.61%;通过单因素分析,年龄、是否接受高等教育、是否合并高血压、是否合并糖尿病、是否合并高血脂、是否有脑梗死病史、脑梗死病灶数量、脑梗死部位、脑梗死面积、是否合并高尿酸血症、血Hcy水平均与认知功能障碍有关(P<0.05);而单因素分析中具有统计学差异的因素进行多因素Logistic回归分析发现,年龄、高血压、糖尿病、有脑梗死病史以及脑梗死的部位、血尿酸增高、血Hcy水平增高均为引发患者脑梗死后发生认知障碍的重要危险因素(P<0.05);经认知护理干预后,患者对护理的满意率为90.0%,明显高于认知护理实施前的63.3%,差异具有统计学意义(P<0.05)。结论患者的年龄、高血压、糖尿病、有脑梗死病史以及脑梗死的部位、血尿酸增高、血Hcy水平增高是引发患者脑梗死后发生认知障碍的危险因素,针对上述危险因素给予认知护理干预能够有效提高患者的护理满意度。Objective To analyze the influencing factors of cognitive dysfunction after cerebral infarction, and to explore the application value of cognitive nursing intervention. Methods A total of 92 patients with cerebral infarction were selected, who were admitted to the Department of Neurology at Xiaogan Central Hospital during January 2017 and February 2018. At the time of admission, they were assessed for cognitive function using the Montreal Cognitive Assessment(MoCA), and the influencing factors for cognitive dysfunction after cerebral infarction were analyzed. Cognitive nursing interventions were then given for relevant risk factors. 2 weeks later, a self-made questionnaire was used to investigate patient’s satisfaction with nursing. Results According to MoCA evaluation, 30 of 92 patients with cerebral infarction had cognitive dysfunction, accounting for 32.61%. The results of univariate analysis showed that many factors were associated with cognitive dysfunction, including age, higher education, hypertension, diabetes, hyperlipidemia, history of cerebral infarction, the number of cerebral infarctions, the location of cerebral infarction, the area of cerebral infarction, hyperuricemia, blood Hcy levels(P<0.05). Multivariate logistic regression analysis was performed on the statistically significant factors in the univariate analysis. The results showed that age, hypertension, diabetes, history of cerebral infarction, site of cerebral infarction, increased blood uric acid levels, elevated blood Hcy levels were the risk factors for cognitive impairment after cerebral infarction(P<0.05). After cognitive nursing intervention, the patient’s satisfaction rate for nursing was 90.0%, which was significantly higher than 63.3% before the implementation of cognitive nursing(P<0.05). Conclusion Age, hypertension, diabetes, history of cerebral infarction, location of cerebral infarction, increased blood uric acid levels, and elevated blood Hcy levels are risk factors for cognitive impairment after cerebral infarction. Givi

关 键 词：脑梗死 认知功能障碍 护理干预 临床效果 影响因素 

分 类 号：R473.74[医药卫生—护理学]