卢伟丽

【摘要】 目的：探讨医养结合延伸护理在中度痴呆患者中的护理效果。方法：选择2016年4月-2018年12月治疗的中度痴呆患者60例作为对象，随机数字表分为对照组（n=30）和观察组（n=30）。对照组给予常规护理，观察组在对照组基础上联合医养、延伸性护理，1个月护理后对患者效果进行评估，比较两组认知功能、不良事件发生率。结果：两组护理后1、2、3及4周MMSE评分，均高于护理前（P<0.05）;观察组护理后不同时间点MMSE评分高于对照组（P<0.05）;观察组护理后1个月误吸、跌倒、走失、噎食呛咳及坠床自伤发生率均低于对照组（P<0.05）。结论：将医养结合延伸护理用于中度痴呆患者中能改善患者认知功能，降低不良事件发生率，值得推广应用。

【关键词】 医养; 延伸护理; 常规护理; 中度痴呆; 认知功能; 不良事件

doi：10.14033/j.cnki.cfmr.2019.27.050 文献标识码 B 文章编号 1674-6805（2019）27-0-03

Nursing Effect of Medical Care Combined with Extended Care in Patients with Moderate Dementia and Its Effect on Cognitive Function/LU Weili.//Chinese and Foreign Medical Research，2019，17（27）：-118

【Abstract】 Objective：To explore the effect of nursing combined with extended nursing on patients with moderate dementia and its impact on cognitive function.Method：Sixty patients with moderate dementia who were treated from April 2016 to December 2018 were enrolled.They were divided into control group（n=30） and observation group（n=30） by random number table.The control group received routine nursing.The observation group was combined with medical care and extended care on the basis of the control group.The effect of the patients was evaluated after 1 month of nursing.The cognitive function and adverse event rate were compared between the two groups.Result：The MMSE scores at 1 week，2 weeks，3 weeks and 4 weeks after treatment were higher than those before treatment （P<0.05）.The MMSE scores of the observation group at different time points after treatment were higher than those of the control group（P<0.05）.The incidence of aspiration，falls，loss，eating and coughing and bed-breaking self-injury in the observation group was lower than those in the control group（P<0.05）.Conclusion：The combination of medical and extended care for patients with moderate dementia can improve the cognitive function of patients and reduce the incidence of adverse events，which is worthy of popularization and application.

【Key words】 Medical care; Extended care; Routine care; Moderate dementia; Cognitive function; Adverse events

First-authors address：Jiangxi Provincial Peoples Hospital，Nanchang 330000，China

癡呆是由于病程缓慢的进行性、大脑疾病所致的综合征，多数患者由于多种高级皮层功能紊乱引起，且常涉及记忆、定向、理解、判断、学习能力等内容。患者虽然意识清晰，但是情感自控能力、社交能力减退，可伴有认知功能损害（部分患者认知功能损害早于临床症状）[1]。临床研究表明，药物治疗痴呆能改善患者认知功能，提高患者自我效能，但是由于患者自控能力较差，缺乏科学合理的护理方法，导致患者治疗依从性较差，增加出院后不良事件发生率[2-3]。延伸护理是通过一系列行动设计包括患者在不同的健康照顾场所、同一健康照护场所为患者提供科学、合理、连续性的护理与指导，但是与医养干预联合对痴呆患者认知功能的影响研究较少[4]。因此，本文给予病例对照干预方法进行，探讨医养结合延伸护理在中度痴呆中的应用，报道如下。

1 资料与方法

1.1 一般资料

2016年4月-2018年12月中度痴呆患者60例分为两组。纳入标准：（1）均符合痴呆诊断标准[5];（2）疾病严重程度均为中度，入院前未见不良事件发生。……