郭翠英?黎柳章?苏梅香

[摘要] 目的 探討分析卒中单元模式下系统化的健康教育和出院随访对脑卒中患者颈动脉斑块稳定性的影响。 方法 选择我院收治的150例脑卒中患者作为本次研究对象，采用随机数字表的分组原则分为研究组和对照组，其中研究组75例患者予以单元模式下系统化的健康教育和出院随访，对照组75例患者予以神经内科的常规健康教育和出院随访；干预12个月后，比较两组患者的服药依从性、生活方式改变情况、血脂、血糖、血尿酸、颈动脉斑块积分及斑块性质变化情况。 结果 干预前，两组患者各项指标间的差异均无统计学意义（P>0.05）；干预后，研究组患者的服药依从性及生活方式改变情况均优于对照组患者，差异均具有统计学意义（P<0.05）；研究组患者的血甘油三酯（TG）、血胆固醇（TC）、血糖（GLU）及血尿酸（UA）等危险指标均低于对照组患者，差异均具有统计学意义（P<0.05）；研究组患者颈动脉斑块积分及稳定性均优于对照组患者，差异具有统计学意义（P<0.05）。 结论 卒中单元模式下的健康教育和出院随访可明显改变患者的不良生活方式，提高患者的服药依从性，从而有效地控制血脂、血糖、血尿酸等促进颈动脉斑块形成的危险因素，并且可使颈动脉斑块趋于稳定，降低脑卒中的再发风险。

[关键词] 卒中单元模式；颈动脉斑块；脑卒中；稳定性

[中图分类号] R473.7 [文献标识码] A [文章编号] 2095-0616（2017）07-217-04

Influence of systematic health education and discharge follow-up in stroke unit model to the stability of carotid plaques in stroke patients

GUO Cuiying LI Liuzhang SU Meixiang

Chang'an Hospital，Dongguan 523843，China

[Abstract] Objective To explore the influence of systematic health education and discharge follow-up in stroke unit model to the stability of carotid plaques in stroke patients. Methods 150 stroke patients cured in our hospital were selected as the study objects.According to random number table，they were divided into study group and control group.75 cases in study group were treated with systematic approach to health education and discharge follow-up，and 75 cases in control group were treated with routine health education and discharge follow-up in neurology department.After 12 months of intervention， medication compliance， lifestyle changes，blood lipids，blood glucose，serum uric acid，carotid plaque score and plaque characteristics of the two groups were compared. Results Before intervention，there was no significant difference between the two groups（P>0.05）.After intervention，the terms of medication compliance and lifestyle changes in the study group were significantly better than those in the control group（P<0.05）.The serum triglyceride（TG），serum cholesterol（TC），blood glucose （GLU） and serum uric acid （UA） in the study group were significantly lower than those in the control group（P<0.05）.The carotid plaque score and stability of the study group were better than those of the control group，the difference was statistically significant （P<0.05）. Conclusion Health education and discharge follow up in stroke unit model can significantly change the unhealthy life style of patients，and improve the medication compliance of patients.So as to effectively control the risk factors of carotid plaque formation，such as blood lipid， blood glucose and serum uric acid.It can make the carotid artery plaque stable and reduce the risk of recurrent stroke.

[Key words] Stroke unit model；Carotid plaque；Stroke；Stability

腦卒中是指由于多种因素导致脑组织血液供应障碍，从而造成的系统性神经功能疾病，具有发病率高、死亡率高和致残率高的特点，是神经系统常见病和多发病，与心脏疾病及恶性肿瘤共同构成人类的三大死因[1-2]。根据流行病学资料，近年来脑卒中每年的发病率都在不断攀升，严重威胁人民的身心健康，大大降低患者的生活质量，因此，最大程度地恢复脑卒中患者的神经功能业已成为临床研究和治疗的重点。脑卒中与动脉硬化密不可分，多数卒中患者并存颈动脉粥样硬化这一临床现象，而颈动脉硬化势必加重脑卒中患者的病情；在……