渐进式早期康复训练干预对急性脑梗死患者生活质量的影响

李静蹈 林桦 张燕燕 谢兴 颜秋媚

【摘要】 目的 探索漸进式早期康复训练改善急性脑梗死患者负性情绪及日常生活能力和生活质量的效果。

方法 选取2018年1月至2020年1月在南宁市第一人民医院住院治疗的60例急性脑梗死患者作为研究对象，根据随机数字表将患者随机分为两组，观察组和对照组各30例。两组均予常规治疗，对照组采用常规护理方法，观察组在对照组基础上实施渐进式早期康复训练干预，观察两组患者焦虑自评量表（SAS）评分、入院日（干预前）和3个月时（干预后）日常生活能力MBI指数评分及生活质量（GQOL-74）评分。

结果 干预前两组SAS评分差异无统计学意义（P>0.05）;干预后两组SAS评分均显著改善（P<0.01），观察组SAS评分改善更明显（P<0.01）。干预前两组MBI指数评分差异无统计学意义（P>0.05）;干预后两组MBI指数评分均显著改善（P<0.01），观察组MBI指数评分改善更明显（P<0.01）。两组干预前GQOL-74评分差异无统计学意义（P>0.05）;干预后观察组GQOL-74评分中生理功能、物质生活、心理状况及社会关系评分高于对照组，差异有统计学意义（P<0.05或0.01）。

结论 渐进式早期康复训练能改善急性脑梗死患者焦虑情绪，提高日常生活能力及生活质量，减轻家庭和社会负担。

【关键词】 急性脑梗死;渐进式早期康复训练;日常生活能力;生活质量

中图分类号：R473.74   文献标志码：A   DOI：10.3969/j.issn.1003-1383.2021.05.005

【Abstract】 Objective To explore the effect of progressive early rehabilitation training on improving negative emotions， ability of daily living and quality of life in patients with acute cerebral infarction.

Methods From January 2018 to January 2020， 60 patients with acute cerebral infarction who were hospitalized in the First People's Hospital of Nanning were selected as research objects. All patients were divided into observation group and control group according to random number table， with 30 cases in each group. Both groups were treated with conventional treatment. The control group were given conventional nursing methods， and the observation group were given progressive early rehabilitation training intervention on the basis of the control group. And then， self-rating anxiety scale （SAS） scores as well as MBI scores of activity of daily living and generic quality of life inventory-74 （GQOL-74） scores on admission date （before intervention） and the 3rd month （after the intervention） were observed between the two groups.

Results There was no statistically significant difference in SAS scores between the two groups before intervention （P > 0.05）; after intervention， the SAS scores of the two groups significantly improved （P < 0.01）， and that of the observation group improved more significantly （P < 0.01）. There was no statistically significant difference in MBI scores between the two groups before intervention （P > 0.05）; after intervention， the MBI scores of the two groups significantly improved （P < 0.01）， and the improvement in the observation group was more obvious （P < 0.01）. There was no statistically significant difference in GQOL-74 scores between the two groups before intervention （P > 0.05）; after intervention， the scores of physiological function， material life， psychological status and social relations of GQOL-74 scores in the observation group were higher than those in the control group， and difference was statistically significant （P < 0.05 or 0.01）.

Conclusion Progressive early rehabilitation training can improve the anxiety of patients with acute cerebral infarction， improve the ability of daily living and the quality of life， and reduce the burden on both family and society.

【Key words】 acute cerebral infarction; progressive early rehabilitation training; ADL; quality of life

急性脑梗死是由诸多原因所致脑部血液供应障碍，可使脑部神经发生不可逆转损伤;具有突然发病、致残率高等特点。多在睡眠或者安静状态下发病且病情发展1～2天内达到高峰[1]。中老年人是急性脑梗死高发人群。急性脑梗死尚缺乏有效的治疗手段，致残率和并发症发生率仍较高[2]，致使患者日常生活自理能力严重下降，不仅给家庭及社会带来一定负担，还会导致患者出现不同程度心理障碍，从而影响康复训练，不利于相关功能恢复[3～4]。如何……