张玥

[摘要]目的 探讨延续性护理在老年高血压合并脑卒中患者中的应用。方法 选取2017年11月～2019年1月我院收治的80例急性缺血性脑卒中（AIS）患者作为研究对象，按照实施护理方法不同分为观察组（40例）和对照组（40例）。对照组实施常规护理，观察组则在对照组基础上实施出院后延续性护理，比较干预后3个月，两组机体营养状况中蛋白指标、饮水及进食能力变化情况，统计干预后6个月两组欧洲脑卒中评分（ESS）分值和Barthel指數情况。结果 干预3个月后，观察组转铁蛋白、前清蛋白、清蛋白水平高于对照组，差异均有统计学意义（P<0.05），干预3个月后，观察组的饮水能力和经口进食能力恢复时间短于对照组，差异均有统计学意义（P<0.05）;随访6个月，观察组的ESS评分和Barthel指数高于对照组，差异均有统计学意义（P<0.05）。结论 对AIS患者实施延续性护理，能确保机体营养状况，减少吞咽困难，改善神经功能，提高患者生活质量。

[关键词]延续性护理;高血压;脑卒中;营养状况;吞咽情况;神经功能

[中图分类号] R473.5          [文献标识码] A          [文章编号] 1674-4721（2020）3（a）-0237-03

Application of continuous nursing in elderly patients with hypertension complicated with stroke

ZHANG Yue

Department of Rehabilitation， Shenyang First People′s Hospital， Liaoning Province， Shenyang   110041， China

[Abstract] Objective To explore application of continuous nursing in elderly patients with hypertension complicated with stroke. Methods A total of 80 patients with acute ischemic stroke （AIS） admitted to our hospital from November 2017 to January 2019 were selected as the research objects， and divided into observation group （40 cases） and control group （40 cases） according to different nursing methods. The control group received routine nursing while the observation group received continuous nursing after discharge based on the control group. The changes of protein index， drinking water and eating ability in the nutritional status of the two groups at 3 months after the intervention were compared， and the European stroke score （ESS） score and Barthel index of the two groups at 6 months after the intervention were counted. Results After 3 months of intervention， the levels of transferring， prealbumin and albumin in the observation group were higher than those in the control group， and the differences were statistically significant （P<0.05）. After 3 months of intervention， the recovery time of drinking water capacity and oral feeding capacity in the observation group was shorter than that in the control group， and the differences were statistically significant（P<0.05）. Following up for 6 months， the ESS score and Barthel index of the observation group were higher than those of the control group， and the differences were statistically significant （P<0.05）. Conclusions Continuous nursing for AIS patients can ensure the nutritional status of the body， reduce dysphagia， improve neurological function and improve the quality of life of patients.

[Key words] Continuous nursing; Hypertension; Stroke; Nutritional status; Swallowing condition; Neurological function

缺血性脑卒中（AIS）为临床相对常见心脑血管疾病，发病后多数患者处于昏迷状态，同时机体发生严重的应激反应，血糖升高，机体代谢指数增加，出现负氮平衡[1]。对AIS患者未能及时救治，将遗留多种功能障碍，尤其以肢体运动功能障碍为主，对患者发病后生活质量造成较大负面影响，最终导致患者病程延长甚至临床死亡[2]。AIS康复是一个长期过程，出院后的护理至关重要[3]，对提高患者治疗依从性，减少疾病再发，提高患者生活质量有重要价值。对AIS出院后应给予有效的护理干预十分必要[4]。延续护理则可将院内护理服务延伸至院外，对患者出院后状况进行持续性护理干预，对提高治疗依从性，改善患者预后有积极意义[5]。本研究探讨延续性护理对提高老年高血压合并AIS患者的营养状况，减少吞咽困难发生及提高生活质量的效果，现报道如下。……