康复护理结合心理干预对脑卒中患者中的应用

东志远+王玉龙

[摘要] 目的 分析康復护理结合心理干预对脑卒中患者中的应用效果。方法 选取我院收治的脑卒中患者166例，采取数字随机法分成观察组和对照组，对照组采取康复护理，观察组在此基础上，采取心理干预，比较两组护理方式应用效果。结果 两组护理4、8周Fugl-Meyer、FIM评分均高于护理前，差异有统计学意义（P<0.05）。两组护理8周Fugl-Meyer评分均高于护理4周，差异有统计学意义（P<0.05）。观察组护理8周Fugl-Meyer评分高于对照组，差异有统计学意义（P<0.05）。观察组护理4、8周FIM评分均高于对照组，差异有统计学意义（P<0.05）。观察组护理4、8周神经功能缺损评分、Bathel指数均优于护理前，差异有统计学意义（P<0.05）。对照组护理4、8周神经功能缺损评分优于护理前，护理8周Bathel指数优于护理前，差异有统计学意义（P<0.05）。两组护理8周神经功能缺损评分、Bathel指数均优于护理4周，差异有统计学意义（P<0.05）。观察组护理8周神经功能缺损评分、Bathel指数均优于对照组，差异有统计学意义（P<0.05）。两组护理后SAS及SDS评分均低于护理前，差异有统计学意义（P<0.05）。观察组护理后SAS及SDS评分均低于对照组，差异有统计学意义（P<0.05）。结论 康复护理结合心理干预对脑卒中患者十分有利，可明显改善患者各项评分，是优秀的护理方法。

[关键词] 康复护理；心理干预；脑卒中；神经功能缺损

[中图分类号] R473.74 [文献标识码] A [文章编号] 2095-0616（2017）13-81-04

[Abstract] Objective To analyze the effect of rehabilitation nursing combined with psychological intervention on patients with stroke. Methods 166 stroke patients in our hospital were selected and randomly divided into the observation group and the control group. Patients in control group were treated with rehabilitation nursing， on the basis of this， patients in observation group were treated with application effect of psychological intervention. The application effect of the two nursing methods was compared. Results The Fugl-Meyer and FIM scores of the two groups were higher than those before nursing at the end of the 4 and 8 weeks， and the difference was statistically significant（P<0.05）. The 8 groups of Fugl-Meyer score of the two groups were higher than those of nursing for 4 weeks， the difference was statistically significant（P<0.05）. The Fugl-Meyer score of the observation group was higher than that of the control group at 8 weeks， the difference was statistically significant （P<0.05）. The FIM score of the observation group was higher than that of the control group at 4 and 8 weeks， the difference was statistically significant（P<0.05）. The neurological deficit score and Bathel index of the observation group were better than those before nursing at 4 and 8 weeks after treatment， and the difference was statistically significant（P<0.05）. In the control group， the neurological deficit score of 4 and 8 weeks after treatment was better than that before nursing care， and the Bathel index was better than that before nursing at the end of the nursing for 8 weeks， the difference was statistically significant （P<0.05）. The neurological deficit score and Bathel index of two groups were better than those of nursing for 4 weeks， and the difference was statistically significant（P<0.05）. The neurological deficit score and Bathel index of the observation group were better than those of the control group at 8 weeks， the difference was statistically significant（P<0.05）. The SAS and SDS scores of the two groups were lower than those before nursing， and the difference was statistically significant（P<0.05）. The SAS and SDS scores of the observation group were lower than those of the control group， the difference was statistically significant（P<0.05）. Conclusion The rehabilitation nursing combined with psychological intervention for stroke patients is very beneficial. It can significantly improve the score of patients， is an excellent nursing method.

[Key words] Rehabilitation nursing； Psychological intervention； Stroke

腦卒中发病率和致残率均较高，需要适宜的治疗和临床护理，在脑卒中康复护理的过程中，患者可能存在许多心态问题，影响患者的治疗，因此除康复护理外，还需要对患者心理情况进行干预，而常规的护理方法并未针对患者心理进行调整，因此难以收到较好的干预效果，在脑卒中的康复护理中，联合专业的心理护理是具有可行性的一种改良护理方法[1-2]。本研究对康复护理结合心理干预对脑卒中患者中的应用效果进行观察，现报道如下。

1 资料与方法

1.1 一般资料

我院自2015年4月～2016年11月收治的脑卒中患者166例，纳入标准：自愿签署知情同意书者，可配合护理者，年龄<80岁者；排除标准：恶性肿瘤者，精神疾病者，合并心、脑、肾、肝等重要脏器疾病者；采取数字随机法分成观察组和对照组，观察组83例，其中男45例，女38例，年龄在40～76岁，平均（56.8±5.7）岁，平均GCS评分（8.1±1.7）分，其中脑梗死67例，脑出血16例；对照组83例，其中男47例，女36例，年龄在39～75岁，平均（56.1±5.8）岁，平均GCS评分（8.3±1.4）分，其中脑梗死65例，脑出血18例；两组患者一般资料比较，差异无统计学意义（P>0.05）。……