中医临床护理路径对缺血性脑卒中急性期的临床治疗影响

摘要

目的 探讨中医临床护理路径管理对缺血性脑卒中急性期患者康复水平、生活指数、平均费用及住院时间等方面的影响.方法 选取本科2016年1 1月至2017年10月住院缺血性脑卒中急性期患者220例进行护理管理,按随机原则将220例缺血性脑卒中患者分为研究组(110例)与对照组(110例);两组患者均采用常规临床治疗,研究组纳入中医临床护理路径干预相结合的综合性护理管理,连续观察2周;对入组前、研究开始1周、2周时分别记录两组患者治疗前后中医护理效果评价表、NIHSS、BI、卒中后抑郁发生及干预效果,患者对护理工作满意度调查表、住院时间、医疗费用等进行统计评估.结果 治疗组110例,痊愈44例,显效38例,有效20例,无效8例,总有效率92.7％;对照组110例,痊愈35例,显效33例,有效18例,无效24例,总有效率78.2％;两组痊愈率、显效率、总有效率比较,差异均有统计学意义(均P＜ 0.05).护理前两组NIHSS评分比较,差异无统计学意义(P＞0.05);护理后,两组NIHSS评分比较,差异有统计学意义(P＜0.05).两组平均住院天数及平均住院费用比较,差异均有统计学意义(均P＜ 0.05).结论 采取中医特色护理及临床路径管理,能够有效改善患者病情,减少平均住院时间及住院费用,能够减轻患者的家庭负担,具有临床推广价值.%Objective To explore the influence of clinical nursing pathway management of traditional Chinese medicine on the rehabilitation level,living index,average cost,and length of hospital stay of patients with acute ischemic stroke.Methods 220 patients acute ischemic stroke treated at our hospital from November,2016 to October,2017 were select and undergent nursing management.According to the random principle,the patients were divided into a study group (110 cases) and a control group (110 cases).Both groups took conventional clinical treatment.The study group were intervened by comprehensive nursing care management and TCM clinical nursing pathway.The patients were observed for two weeks.Before and one and two weeks after the beginning of the study,the TCM nursing effect,scores of stroke scale (NIHSS) and Barthel Index assessment form (BI),poststroke depression,and intervention effect (Fugl-Meyer rating scale evaluation) were recorded.And the patients satisfaction to nursing care,length of hospital stay,and medical cost were recorded.Results In the study group,44 cases were cured,38 markedly effectively treated,20 effectively treated,and 8 ineffectively treated,with a total effective rate of 92.7％;and in the control group,35,33,18,and 24,with a total effective rate of 78.2％ (P ＜ 0.05).There was no statistical difference in the score of NIHSS before the nursing care (P ＞ 0.05) but was after (P ＜ 0.05) between these two groups.There were statistical differences in the hospital stay and hospitalization cost between these two groups (P ＜ 0.05).Conclusions Clinical nursing pathway of traditional Chinese medicine for patients with acute ischemic stroke can effectively improve their conditions,shorten their hospital stay,and reduce their hospitalization cost and family burden,so it is worth being clinically generalized.