何会超++张伟滨+吕政

[摘要] 目的 探究与分析早期护理干预对脑卒中偏瘫失语患者日常生活能力及负性情绪的影响。 方法 选取哈尔滨医科大学附属第一医院2014年1月～2016年1月收治的90例脑卒中偏瘫失语患者，采用随机数字表法分为对照组与观察组，每组各45例。对照组给予常规护理，观察组给予早期护理干预，对比两组患者理解能力、表达能力、下肢运动功能、步行能力、日常生活能力及负性情绪。 结果 与护理前比较，两组患者护理后理解能力、表达能力评分均升高；观察组与对照组相比，理解能力、表达能力评分改善更加显著，差异有统计学意义（P < 0.05）。与护理前比较，两组患者护理后简式Fugl-Meyer运动功量表（FMA）、功能性步行分级（FAC）和日常生活能力（Barthel）指数评分均升高；与对照组比较，观察组FMA、FAC及Barthel指数评分改善更加显著，差异有统计学意义（P < 0.05）。与护理前比较，两组患者护理后汉密尔顿焦虑量表（HAMA）和汉密尔顿抑郁量表（HAMD）评分均降低；與对照组比较，观察组HAMA及HAMD评分改善更加显著，差异有统计学意义（P < 0.05）。 结论 将早期护理干预应用于脑卒中偏瘫失语患者中可显著提高理解能力及表达能力，促进改善肢体运动功能及日常生活能力，降低负性情绪。

[关键词] 早期护理干预；脑卒中；偏瘫；失语；日常生活能力；负性情绪

[中图分类号] R473 [文献标识码] A [文章编号] 1673-7210（2017）01（b）-0146-04

The effects of daily life ability and negative emotions on the early rehabilitation nursing intervention in patients with cerebral apoplexy hemiplegia

HE Huichao ZHANG Weibin LU Zheng HAN Kebing

Department of Rehabilitation， the First Clinical Hospital Affiliated to Harbin Medical University， Heilongjiang Province， Harbin 150001， China

[Abstract] Objective To explore the influence of early rehabilitation nursing intervention in patients with cerebral apoplexy hemiplegia on daily life abilityand the effects of negative emotions. Methods 90 cases with cerebral apoplexy hemiplegia treated in the First Clinical Hospital Affiliated to Harbin Medical University from January 2014 to January 2016 were selected and divided into control group and observation group， according to the random number table， with 45 cases in each group. The patients in control group were given routine nursing care， and the patients in observation group were given early nursing intervention. The understanding ability， expression ability， daily life ability and negative emotions of the patients in two groups were compared. Results The understanding ability， expression ability scores of two groups after nursing were higher than those before nursing， and the scores of observation group were higher than those of control group， with statistically significant differences （P < 0.05）. The Fugl-Meyer assessment， functional ambulation category and Barthel index scores of two groups after nursing were higher than those before nursing， and the scores of the observation group were higher than those of control group， with statistically significant differences （P < 0.05）. The Hamilon anxiety scale and Hamilton depression scale scores of two groups after nursing were lower than those before nursing， and the scores of the observation group were lower than those of control group， with statistically significant differences （P < 0.05）. Conclusion The early rehabilitation nursing intervention can effectively promote the recovery of limb function， reduce anxiety depression in the stroke patients with hemiplegia and aphasia.

脑卒中是急性脑血管循环障碍导致的局限或全面性脑功能损伤综合征，表现为不省人事、半身不遂、口眼歪斜、智力障碍等症状，具有预后差，致残率、死亡率较高等特点，是临床上一类发病率较高的急性脑血管事件，对患者的生命健康造成较大威胁[1]。大量临床资料显示，脑卒中偏瘫患者在临床上可表现出不同程度的言语功能障碍，不仅降低患者的日常生活质量，同时也造成较大的心理压力[2]。现哈尔滨医科大学附属第一医院（以下简称“我院”）针对收治的90例脑卒中偏瘫失语患者分别给予常规护理与早期护理干预，对比二者康复情况，结果报道如下：

1 资料与方法

1.1 一般资料

选取2014年1月～2016年1月我院收治的脑卒中偏瘫失语患者90例，纳入及排除标准符合第四届全国脑血管病学术会议诊断标准；……