马琰 林伟 张明晖 王鹏军

[摘要] 目的 探討优质护理在阿尔兹海默症患者中的应用价值及对患者认知功能障碍和生活能力的改善效果。 方法 选取2015年1月～2016年12月在哈尔滨医大学附属第四医院门诊部就诊的阿尔兹海默症患者200例作为研究对象，按照数字表法随机分为观察组和对照组，每组各100例。对照组给予常规护理模式，观察组给予优质护理干预。采用简易精神状态检查表（MMSE）、蒙特利尔认知评估量表（MoCA）、阿尔茨海默病认知功能评定量表（ADAS-cog）、阿尔茨海默病协作研究日常能力量表（ADCS-ADL）对两组患者的认知功能和生活能力进行评价。 结果 护理前两组患者MMSE、MoCA、ADAS-cog及ADCS-ADL评分比较，差异无统计学意义（P > 0.05）。护理后3、6个月观察组MMSE、MoCA、ADCS-ADL评分均明显高于对照组，ADAS-cog评分低于对照组，差异均有统计学意义（均P < 0.05）。 结论 优质护理能够有效改善阿尔兹海默症患者的认知功能障碍和日常生活能力，有助于提高患者的独立生活能力，减轻家庭负担，值得在临床中推广使用。

[关键词] 优质护理；阿尔兹海默症；认知功能障碍；生活能力

[中图分类号] R473.5 [文献标识码] A [文章编号] 1673-7210（2018）02（a）-0156-04

The effect of quality nursing on cognitive dysfunction and life ability of alzheimer′s patients

MA Yan1 LIN Wei1 ZHANG Minghui2 WANG Pengjun2

1.Outpatient Department， the Fourth Affiliated Hospital of Harbin Medical University， Heilongjiang Province， Harbin 150001， China； 2. the Second Department of Neurology， the Fourth Affiliated Hospital of Harbin Medical University， Heilongjiang Province， Harbin 150001， China

[Abstract] Objective To explore the application value of quality nursing in patients with Alzheimer′s disease and the improvement in cognitive dysfunction and living ability. Methods From January 2015 to December 2016， 200 patients with Alzheimer′s disease in the Outpatient Department， the Fourth Affiliated Hospital of Harbin Medical University were selected and divided into the observation group and the control group by random number table， with 100 cases in each group. The control group was given routine nursing mode and the observation group was given high quality nursing intervention. The mini-mental state examination （MMSE）， Montreal cognitive assessment scale （MoCA）， Alzheimer′s disease assessment scale （ADAS-cog）， Alzheimer′s disease cooperative study ADL （ADCS-ADL） were applied to evaluate the cognitive function and the living ability in the two groups. Results Before nursing， there were no statistically significant differences in the scores of MMSE， MoCA， ADAS-cog and ADCS-ADL （P > 0.05）. After nursing of 3 month and 6 month， the scores of MMSE， MoCA and ADCS-ADL in the observation group were all significantly higher than those of control group， the scores of ADAS-cog was lower than that of control group， with statistically significant differences （all P < 0.05）. Conclusion Quality nursing can improve the cognitive function and daily living ability of Alzheimer′s patients. It can improve the independent living ability and reduce the burden of family. It is worthy of promotion and application.

[Key words] Quality care； Alzheimer′s disease； Cognitive dysfunction； Living ability

阿尔兹海默症是一种神经退行性疾病，主要表现为进行式、不可逆性的记忆损失以及认知功能障碍，是老年人群常见的疾病[1]。2016年WHO数据报告指出，我国每年约有75万新增阿尔兹海默症患者，且随着人口老龄化趋势的增加，该数字还会持续增长。该病的出现对于患者的正常生活与社交造成了严重的影响，目前临床对于该病的发生原因和发病机制尚未清晰，因此存在较大的治疗难度。目前主要采用药物治疗法，但效果不佳，需要采用其他的方式来提高患者的认知能力和生活能力[2]。优质护理干预主要是通过全方面的干预措施来改善患者的认知能力和生活能力，从而减轻家庭的负担。因……