基于老年综合评估的分级护理方案在老年高血压脑出血患者术后的应用研究  

Application of comprehensive geriatric assessment based graded nursing in elderly patients with hypertensive intracerebral hemorrhage after surgery

作　　者：陈琳 张洁 周西广 王玉 CHEN Lin;ZHANG Jie;ZHOU Xi-guang;WANG Yu(Physical Examination Center,Xingtai Central Hospital,Xingtai 054000,Hebei,China;Department of Neurosurgery,Xingtai Central Hospital,Xingtai 054000,Hebei,China)

机构地区：[1]邢台市中心医院,体检中心,河北邢台054000 [2]邢台市中心医院,神经外科,河北邢台054000

出　　处：《川北医学院学报》2024年第12期1719-1723,共5页Journal of North Sichuan Medical College

基　　金：河北省邢台市重点研发计划项目(2022ZC100)。

摘　　要：目的:探讨基于老年综合评估(CGA)的分级护理方案在老年高血压脑出血患者术后的应用效果。方法:选取接受手术治疗的106例老年高血压脑出血患者作为研究对象,按照护理方式不同将患者分为对照组(常规护理,n=53)和CGA组(基于CGA的分级护理,n=53)。干预时间均为2个月,比较两组患者术后当天(意识恢复后)、术后2个月的焦虑状态、营养状态、家庭照顾负担及术后2个月的日常生活活动能力,记录干预期间两组患者便秘、跌倒发生情况。结果:术后2个月,CGA组焦虑自评量表(SAS)评分低于对照组(P<0.05),CGA组日常生活活动能力(ADL)量表评分高于对照组(P<0.05),CGA组血清前白蛋白、白蛋白、转铁蛋白水平均高于对照组(P<0.05),CGA组家庭健康状况、家属精神状态、家属与患者的关系、社会生活及Zarit照顾者负担量表(ZBI)总分均低于对照组(P<0.05),CGA组患者术后2个月内便秘、跌倒发生率均低于对照组(P<0.05)。结论:基于CGA的分级护理方案有利于改善老年高血压脑出血患者心理状态、营养状态及日常生活能力,缓解家属照顾负担。Objective:To investigate the effect of comprehensive geriatric assessment(CGA)based graded nursing plan in elderly patients with hypertensive intracerebral hemorrhage after surgery.Methods:106 elderly hypertensive cerebral hemorrhage patients admitted for surgical treatment were selected,and they were divided into a control group(conventional nursing,n=53)and a CGA group(graded nursing based on CGA,n=53)according to different nursing methods.The intervention period was 2 months,the anxiety status,nutritional status,and family care burden of two groups of patients on the day after surgery(after recovering consciousness)and 2 months after surgery,and the daily living activities of the two groups of patients 2 months after surgery were compared between the two groups,and the occurrence of constipation and falls during the intervention period were recorded.Results:2 months after surgery,the Self-rating anxiety scale(SAS)score of the CGA group was lower than that of the control group(P<0.05),the Activities of daily living(ADL)score of the CGA group was higher than that of the control group(P<0.05),the serum levels of prealbumin,albumin,and transferrin in the CGA group were higher than those of the control group(P<0.05),the family health status,family mental state,family patient relationship,social life,and Zarit caregiver burden interview(ZBI)total score of the CGA group were lower than those of the control group(P<0.05),and the incidence of constipation and falls in the CGA group was lower than that of the control group within 2 months after surgery(P<0.05).Conclusion:The graded nursing plan based on CGA is beneficial to improve the psychological state,nutritional state and daily living ability of elderly patients with hypertensive cerebral hemorrhage,and alleviate the burden of family care.

关 键 词：老年综合评估 分级护理 高血压性脑出血 焦虑 日常生活能力 营养 照顾负担 

分 类 号：R248.2[医药卫生—中医临床基础]