袁瑛 王秀艳

[摘要] 目的 探討预见性护理在脑出血伴偏瘫患者肢体功能康复中的应用效果。 方法 选取我院2017年2月～2018年7月收治的脑出血伴偏瘫患者61例为研究对象，采用随机数字表法将其分为对照组（31例）和观察组（30例），对照组采用常规护理方案，观察组在此基础上实施预见性护理，护理干预持续4周。比较护理前后两组患者的神经功能缺损情况、肢体运动功能、日常生活质量变化及并发症发生情况。 结果 护理前，两组神经功能缺损情况、肢体运动功能、日常生活质量各项评分比较，差异无统计学意义（P>0.05）。护理后，两组患者Fugl-Meyer运动功能评分较护理前均升高，且护理后2周、护理后4周，观察组评分均明显高于同期对照组，差异均有统计学意义（P<0.05）。护理后2周、护理后4周，两组患者NIHSS评分较护理前均降低，且观察组NIHSS评分均低于同期对照组;护理后两组脑出血患者生活质量评分比较，观察组显著高于对照组，差异有统计学意义（P<0.05）。两组患者术后并发症发生率比较，差异无统计学意义（P>0.05）。 结论 对脑出血伴偏瘫患者实施预见性护理，可提高患者生活质量，降低神经功能缺损，改善其肢体运动功能，促进神经系统功能康复，有一定的临床应用价值。

[关键词] 预见性护理;脑出血;偏瘫;肢体功能康复

[中图分类号] R473.6          [文献标识码] B          [文章编号] 1673-9701（2019）18-0146-04

[Abstract] Objective To investigate the effect of predictive nursing on the rehabilitation of limb function in patients with cerebral hemorrhage and hemiplegia. Methods A total of 61 patients with cerebral hemorrhage and hemiplegia admitted in our hospital from February 2017 to July 2018 were enrolled in the study. They were randomly divided into the control group（31 cases） and the observation group（30 cases）. The control group used a routine care program， and the observation group implemented predictive care on this basis. The nursing intervention lasted for 4 weeks. The neurological deficits， limb motor function， quality of daily life and complications were compared between the two groups before and after treatment. Results Before the nursing， there were no significant differences in the scores of neurological deficits， limb movement supply， and quality of daily life between the two groups（P>0.05）. After the nursing， the Fugl-Meyer motor function scores of the two groups were higher than those before the nursing， and the scores of the observation group were significantly higher than those of the control group at 2 weeks and 4 weeks after the nursing. The difference was statistically significant（P<0.05）. At two weeks and 4 weeks after the nursing， the NIHSS scores of the two groups were lower than those before the nursing， and the NIHSS scores of the observation group were lower than those of the control group. The quality of life scores of the observation group after nursing were significantly higher than those of the control group， and the difference was statistically significant（P<0.05）. There was no significant difference in the incidence of postoperative complications between the two groups（P>0.05）. Conclusion Predictive nursing of patients with cerebral hemorrhage and hemiplegia can improve the quality of life of patients， reduce neurological deficits， improve their limb motor function， and promote the recovery of nervous system function. It has certain clinical application value.

[Key words] Predictive nursing; Cerebral hemorrhage; Hemiplegia; Rehabilitation of limb function

脑出血（cerebral hemorrhage）是指非外伤性颅内血管破裂引起的出血，出血原因主要与脑血管病变有关。患者多在运动或情绪激动时发病，常伴有运动或语言功能障碍、头晕头痛、呕吐、意识障碍等。随着医疗水平的提高，脑出血致死率较以往有所降低，但多数患者仍伴有不同程度的肢体功能障碍，严重影响日常生活质量[1-2]。有研究表明，及早为脑出血伴偏瘫患者提供合理的康复及护理，可有效改善其肢体功能，提高生活质量[3]。本研……