CAJ | 학술논문

目的评价脑卒中后认知障碍(PSCI)的早期认知康复护理效果.方法选择60例初次确诊为缺血性脑卒中患者,随机分为观察组和对照组各30例,入院后均接受常规护理,观察组增加两周认知康复护理干预.分别在干预前、干预后采用功能独立性评定(FIM)和Zung氏抑郁自评量表(SDS)联合评估患者的身心状况、认知能力和独立生活能力.结果干预前两组的FIM和SDS量表各分项评分及总分组间差异均无统计学意义(P＞0.05),干预后观察组FIM中各分项评分及总分明显提高,差异均有统计学意义(P＜0.05),SDS中各症状组评分及总分显著降低,差异均有统计学意义(P＜0.01)；对照组干预后除运动、交流、社会认知和抑郁性心理障碍外,其他指标的评分及总分均优于干预前,差异均有统计学意义(P＜0.05).干预后两组比较,观察组生活自理、括约肌控制、社会认知评分及总分(103.39±18.41)明显优于对照组(87.77±22.69),差异均有统计学意义(t/t'值分别为7.317,3.215,3.027,2.928;P均＜0.05),但转移、运动和交流方面的得分差异无统计学意义(t值分别为1.669,1.730,1.802；P均＞0.05).结论早期认知康复护理能够促进脑卒中患者身心、认知功能康复,提高其独立生活能力,从而在很大程度上阻止PSCI的进展.
목적 평개뇌졸중후인지장애(PSCI)적조기인지강복호리효과.방법 선택60례초차학진위결혈성뇌졸중환자,수궤분위관찰조화대조조각30례,입원후균접수상규호리,관찰조증가량주인지강복호리간예.분별재간예전、간예후채용공능독립성평정(FIM)화Zung씨억욱자평량표(SDS)연합평고환자적신심상황、인지능력화독립생활능력.결과 간예전량조적FIM화SDS량표각분항평분급총분조간차이균무통계학의의(P＞0.05),간예후관찰조FIM중각분항평분급총분명현제고,차이균유통계학의의(P＜0.05),SDS중각증상조평분급총분현저강저,차이균유통계학의의(P＜0.01)；대조조간예후제운동、교류、사회인지화억욱성심리장애외,기타지표적평분급총분균우우간예전,차이균유통계학의의(P＜0.05).간예후량조비교,관찰조생활자리、괄약기공제、사회인지평분급총분(103.39±18.41)명현우우대조조(87.77±22.69),차이균유통계학의의(t/t'치분별위7.317,3.215,3.027,2.928;P균＜0.05),단전이、운동화교류방면적득분차이무통계학의의(t치분별위1.669,1.730,1.802；P균＞0.05).결론 조기인지강복호리능구촉진뇌졸중환자신심、인지공능강복,제고기독립생활능력,종이재흔대정도상조지PSCI적진전.
Objective To evaluate the effect of early cognitive rehabilitation nursing on patients with post-stroke cognitive impairment.Methods Sixty patients who initially diagnosed as ischemic stroke were randomly divided into experimental group and control group.All of them received routine nursing after admission.In addition,the patients in the experimental group received cognitive rehabilitation nursing for two weeks.The patients were measured with Functional Independence Measure (FIM) and Self-Rating Depression Scale (SDS) before and after intervention to measure the condition of their body and psychology,cognition and independent living.Results There was no significant difference in the scores of FIM and SDS between the two groups before intervention (P ＞ 0.05).However,after intervention,in the experimental group,all scores of FIM were significantly higher than before,and all scores of SDS were dramatically lower than before (P ＜0.05).In the control group,only some scores except those of movement,communication,social cognition and psychological symptoms in depression were significantly better than before (P ＜ 0.05).Compared with control group,the majority of scores of experimental group were significantly better than those of before intervention (P ＜0.05),but those of shift,movement and communication were no significant difference (P ＞ 0.05).Conclusions Early cognitive rehabilitation nursing can improve stroke survivors recover in their condition of body and psychology,cognition and independent living,consequently prevent the progressing of PSCI in very great degree.