缺血性卒中合并应激性高血压患者静脉溶栓后出院准备度及相关因素分析  

Analysis of discharge readiness and related factors in patients with ischemic stroke complicated with stress hypertension after intravenous thrombolysis

作　　者：李杰敏 余锋 赵兴利[1] 龙苏生 王美 Li Jiemin;Yu Feng;Zhao Xingli(Department of Neurology,Linquan County People′s Hospital,Fuyang 236000,China)

机构地区：[1]临泉县人民医院神经内科,阜阳236400 [2]中国科学技术大学附属第一医院神经内科

出　　处：《中华保健医学杂志》2023年第6期621-624,共4页Chinese Journal of Health Care and Medicine

基　　金：阜阳市卫生健康委科研项目(FY2021-181)。

摘　　要：目的探讨缺血性脑卒中(IS)合并应激性高血压(SIH)患者静脉溶栓后出院准备度及其相关影响因素。方法选取2020年12月~2022年12月于临泉县人民医院实施静脉溶栓治疗的IS合并SIH患者116例,评价所有患者的出院准备度量表(RHDS)评分,并分析其影响因素。结果IS合并SIH患者RHDS总分为(72.32±15.80)分,所有条目平均分为(6.03±1.32)分,总体接近中等水平。年龄、家族脑卒中史、月收入、居住状况、自理能力、疾病不确定感、并发症种类、溶栓后脑出血、美国国立卫生研究院卒中量表(NIHSS)评分、照顾者准备度量表(CPS)评分、出院准备时间和照顾者综合能力评分是影响IS合并SIH患者静脉溶栓后出院准备度的主要因素,其中年龄≥60岁、独居和并发症种类≥3种是独立危险因素(OR>1,P<0.05),有家族脑卒中史、月收入>5000元、高水平自理能力、低水平疾病不确定感、CPS评分和照顾者综合能力评分是独立保护因素(OR<1,P<0.05)。结论IS合并SIH患者静脉溶栓后的出院准备度处于中等水平,其与患者自身、疾病和照顾者等相关,临床应针对相应的因素给予措施干预。Objective To investigate the readiness for hospital discharge and its related factors in patients with ischemic stroke(IS)complicated with stress-induced hypertension(SIH)after intravenous thrombolysis.Methods A total of 116 patients with IS complicated with SIH who underwent intravenous thrombolysis in our hospital from December 2020 to December 2022 were selected.The readiness for hospital discharge scale(RHDS)were compared and the influencing factors were analyzed.Results The total score of RHDS in IS patients with SIH was(72.32±15.80),and the average score of all items was(6.03±1.32),which was close to the medium level.Age,family history of stroke,monthly income,living condition,self-care ability,uncertainty in illness,type of complications,cerebral hemorrhage after thrombolysis,NIHSS score,CPS score,discharge preparation time and comprehensive ability score of caregivers were the main factors affecting the readiness for discharge of patients with IS and SIH after intravenous thrombolysis.Among them,age≥60 years old,living alone and type of complications≥3 were independent risk factors(OR>1,P<0.05).Family history of stroke,monthly income>5000 yuan,high level of self-care ability,low level of uncertainty,CPS score and comprehensive ability score of caregivers were independent protective factors(OR<1,P<0.05).Conclusion The readiness for hospital discharge of patients with IS combined with SIH after intravenous thrombolysis is at a medium level,which is related to the patient,the disease and the caregiver.Clinical intervention should be given according to the corresponding factors.

关 键 词：缺血性脑卒中 应激性高血压 静脉溶栓 出院准备度 

分 类 号：R743[医药卫生—神经病学与精神病学]