摘要
目的探讨综合护理干预措施对创伤性脑损伤后认知障碍的影响。方法 69例创伤性脑损伤后认知障碍患者随机分为干预组(35例)与对照组(34例)。对照组采用神经外科常规治疗及护理,干预组在神经外科常规治疗及护理的基础上加入综合性认知康复训练。入院时及治疗2个月后均进行改良的Barthel指数(Modified Barthel Index,MBI)评估日常生活活动(activities of daily living,ADL)能力、神经心理学量表蒙特利尔认知评估量表(Montreal Cognitive Assement,MoCA)、简易智能状态检查量表(Mini Mental State Examination,MMSE)评估认知功能。结果急性脑外伤147例患者中出现认知障碍69例,发生率46.9%。治疗2个月后,两组创伤性脑损伤后认知障碍患者的MBI、MMSE、MoCA评分,前后比较,差异有统计学意义(均P<0.05)。与对照组比较,干预组治疗后MBI、MMSE、MoCA评分改善更为显著,差异有统计学意义[MBI:干预组(84.3±6.7) vs.对照组(71.5±6.1),t=6.546,P<0.001; MMSE:干预组(27.5±2.7)vs.对照组(23.2±2.3),t=5.649,P<0.001; MoCA:干预组(26.8±4.5) vs.对照组(22.3±3.6),t=5.331,P<0.001]。累计满意度构成比干预组(94.3%)显著高于对照组(73.5%)(χ~2=5.545,P=0.019)。结论综合护理干预措施对改善创伤性脑损伤后认知障碍有明显效果,值得在临床中推广应用。
Objective To investigate the effect of comprehensive nursing intervention on cognitive impairment for patients following traumatic brain injury.Methods 69 patients with cognitive impairment following traumatic brain injury were randomly divided into the intervention group（ 35 cases） and the control group（ 34 cases）. The control group was treated with conventional neurosurgical treatment and nursing. The intervention group was involved in comprehensive cognitive rehabilitation training on the basis of routine neurosurgery and nursing. Modified Barthel Index（ MBI） was used to assess the activities of daily living（ ADL） ability,MoCA（ Montreal Cognitive Assement） and MMSE（ Mini getting State Examination） was used to assess cognitive function on admission and 2 months after the treatment,respectively. Results Among the 147 patients with acute brain trauma,69 patients displayed cognitively impaired（ the incidence was 46. 9%）. After 2 months of treatment,the MBI,MMSE and MoCA scores of the two groups with post-traumatic brain injury were significantly improvement（ all P〈0.05）. Compared with the control group,the improvement of MBI,MMSE and MoCA score in the intervention group was more significant,respectively [MBI： intervention group（ 84. 3 ± 6. 7） vs. control group（ 71.5±6.1）,t = 6.546,P〈0.001; MMSE： intervention group（ 27.5±2.7） vs. control group（ 23.2±2.3）,t =5.649,P〈0.001; MoCA： intervention group（ 26.8±4.5） vs. control group（ 22.3±3.6）,t = 5.331,P〈0.001].The cumulative satisfaction degree was significantly higher in the intervention group（ 94. 3%） than that of control group（ 73.5%）（ χ~2= 5.545,P = 0.019）.Conclusions Comprehensive nursing intervention has obvious effect on improving cognitive impairment after traumatic brain injury,and it is worthy to be popularized and applied in clinic.
作者
庄娟娟
任红俤
ZHUANG Juan-juan(Department of Neurosurgery,Fujian Provincial Hospital,Fuzhou,Fujian,350001,China.)
出处
《齐齐哈尔医学院学报》
2018年第13期1587-1589,共3页
Journal of Qiqihar Medical University
关键词
创伤性脑损伤
认知障碍
干预护理
Traumatic brain injury
Cognitive impairment
Nursing intervention
