三位一体分段式护理在脑卒中后认知障碍患者中的应用分析  

Analysis of the application of trinity stage nursing in patients with cognitive impairment after stroke

作　　者：姚志萍 王昳丽[1] 戴翠娴 倪英[1] Yao Zhiping;Wang Yili;Dai Cuixian;Ni Ying(Department of Geriatrics,Huashan Hospital,Fudan University,Shanghai,200042,P.R.China)

机构地区：[1]上海复旦大学附属华山医院老年医学科,上海200042

出　　处：《老年医学与保健》2023年第2期330-335,共6页Geriatrics & Health Care

基　　金：上海市卫生健康委员会科研课题(202040089)。

摘　　要：目的 探讨三位一体分段式护理在脑卒中后认知障碍患者中的应用分析。方法 选择2021年1月—2022年6月在复旦大学附属华山医院老年病科、神经内科、记忆门诊就诊及住院的160例脑卒中后认知障碍患者,随机分为2组,每组80例,均给予针灸配合药物治疗。对照组使用常规康复护理,观察组使用三位一体分段式护理。对比2组的临床疗效、中文版简易智能检查量表(Mini-mental State Examination, MMSE)、中文版蒙特利尔认知量表(Montreal cognitive assessment, MoCA)、 Barthel指数(BarthelIndex, BI)、功能独立性评定量表(Function Independent Measure, FIM)、老年抑郁量表(GDS-30)。结果 观察组治疗有效率为95.00%,明显高于对照组的81.25%(P<0.05);干预6个月的MMSE评分中记忆力、注意力、定向力、语言能力、理解及推理能力等维度相比,观察组得分均更高(P<0.05);干预6个月的MoCA评分中命名、注意、定向、延迟记忆、视空执行功能、抽象、语言等维度相比,观察组得分均更高(P<0.05);干预6个月后BI指数、 FIM评分、 GDS-30评分相比,观察组前2个量表得分均更高,而第3个量表得分明显降低(P<0.05)。结论 将三位一体分段式护理应用于脑卒中后认知障碍患者的护理之中可促进患者认知功能以及情绪状态的显著改善,提高其日常生活和独立生活能力,效果显著。Objective To explore the application of trinity stage nursing in patients with cognitive impairment after stroke.Methods 160 outpatients or inpatients with post⁃stroke cognitive impairment who were admitted to Department of Ger⁃iatrics,Department of Neurology and Memory Clinic of Huashan Hospital Affiliated to Fudan University from January 2021 to June 2022 were selected.They were randomly divided into two groups,with 80 cases in each group.Both groups were given acupuncture combined with drug treatment.The control group received routine rehabilitation nursing,while the observation group received trinity stage nursing.The clinical efficacy and scores of the Chinese version of Mini⁃mental State Examination(MMSE),Chinese version of the Montreal Cognitive Assessment(MoCA),Barthel Index(BI),Function Independence Measure(FIM),and Geriatric Depression Scale(GDS⁃30)were compared between the two groups.Results The effective rate of the observation group was 95.00%,which was significantly higher than that of the control group(81.25%)(P<0.05).After 6 months of intervention,compared with the control group,the dimension scores of memory,attention,orientation,lan⁃guage ability,understanding,reasoning ability and other dimensions in MMSE of the observation group were higher(P<0.05);the dimension scores of naming,attention,orientation,delayed memory,visual executive function,abstraction language and other dimensions in MoCA of the observation group were higher(P<0.05);BI index and FIM score of the observation group were higher,while GDS⁃30 score was significantly lower(P<0.05).Conclusion The application of trinity stage nursing to patients with cognitive impairment after stroke can significantly improve the cognitive function and emotional state of patients,enhance their daily life and independent living ability,and achieve significant results.

关 键 词：脑卒中后认知障碍 三位一体分段式护理 中西医结合治疗 效果 认知功能 

分 类 号：R473.74[医药卫生—护理学]