沃金波　　孙凯丽　　杨海萍　　李海珊　　张燕

[摘要] 目的 近年来，随着生态环境的恶化，各种疾病发生率不断升高，我国每年发生脑小血管疾病人数也随之增加，所以加强对脑小血管疾病的治疗和护理对改善患者预后十分重要。本次研究通过对医院收治脑小血管患者进行精细化护理干预，旨在探讨其应用价值。 方法 选择2019年5月至2020年5月本院脑卒中偏瘫足下垂患者60例，按照1～60号进行编号，并由护理人员随机抽取，其中1～30号为对照组，31～60号为观察组。对照组患者进行常规护理;观察组患者进行精细化护理干预。干預前后分别测量两组步宽、步速和步幅;采用简明运动试验（SPPB）评估患者步态及平衡状况;采用Tinetti量表评估步行质量和动态平衡能力;评估护理质量、护理满意度和护理依从度。 结果 观察组患者干预后步宽为（20.76±1.15）cm，低于对照组（22.69±1.37）cm，观察组患者干预后步速和步幅分别为（32.69±1.67）cm/s和（54.89±4.02）cm，高于对照组（26.95±1.74）cm/s和（47.63±3.69）cm，差异有统计学意义（P<0.05）;观察组患者干预后SPPB总评分和Tinetti总评分分别为（10.13±0.80）分和（23.39±0.85）分，高于对照组（9.01±0.74）分和（21.06±0.91）分，差异有统计学意义（P<0.05）;观察组护理质量、护理满意度和护理依从度评分分别为（97.96±2.01）分、（95.82±2.81）分和（93.91±4.02）分，高于对照组（94.11±1.82）、（91.63±2.58）和（84.22±3.38）分，差异有统计学意义（P<0.05）。 结论 精细化护理干预可显著改善脑小血管患者步态和平衡障碍，效果显著，获得患者肯定。

[关键词] 精细化护理;脑小血管病;步态和平衡障碍;护理质量

[中图分类号] R743.3          [文献标识码] B          [文章编号] 1673-9701（2021）12-0163-04

Application effect of refined nursing in the nursing management of patients with cerebral small vessel disease

WO Jinbo   SUN Kaili   YANG Haiping   LI Haishan   ZHANG Yan

Department of Neurosurgery， Affiliated Hospital of Ningbo University School of Medicine， Ningbo   315020， China

[Abstract] Objective To provide refined nursing intervention for patients with gait and balance disorders in patients with cerebral small vessel disease， to observe its improvement effect on gait and balance disorders in patients， and to evaluate the quality of nursing. Methods Sixty patients with stroke hemiplegia and drop-foot in our hospital from May 2019 to May 2020 were selected and randomly divided into study group and control group， with 30 cases in each group. Patients in the control group received routine care. The patients in the study group received refined nursing intervention. Before and after the intervention， the step width， pace， and step length of two groups were measured respectively. The short physical performance battery（SPPB） was used to assess the patient's gait and balance. The Tinetti scale was used to assess walking quality， dynamic balance ability， the quality of care， nursing satisfaction and nursing adherence. Results The step width of the study group after intervention was（20.76±1.15） cm， which was lower than （22.69±1.37） cm in the control group. The pace and step length of the study group after intervention were（32.69±1.67） cm/s and （54.89±4.02） cm respectively， higher than（26.95±1.74） cm/s and （47.63±3.69） cm in the control group， and the difference was statistically significant （P<0.05）. The total SPPB score and Tinetti total score of the study group after intervention were respectively （10.13±0.80） points and （23.39±0.85） points， higher than （9.01±0.74） points and （21.06±0.91） points in the control group， and the difference was statistically significant（P<0.05）. The scores of nursing quality， nursing satisfaction and nursing adherence in the study group were （97.96±22.01）， （95.82±2.81） and （93.91±4.02） points， which were higher than （94.11±1.182）， （91.63±2.58） and （84.22±3.38） points in the control group， and the difference was statistically significant（P<0.05）. Conclusion Refined nursing intervention can significantly improve the gait and balance disorders of patients with cerebral small vessel disease， and significantly improve the quality and satisfaction of nursing.

[Key words] Refined nursing; Cerebral small vessel disease; Gait and balance disorders; Quality of nursing

脑小血管病引发原因较多，患者主要表现为记忆力下降和平衡障碍及步态障碍等，给其生活造成极大影响，并给社会和家庭带来极大的负担，所以积极给予治疗和护理以促进患者康复，对提升患者生活质量和降低社会压力具有重要作用。脑小血管患者存在步态和平衡障碍，这给患者日常生活和工作等造成严重影响，所以恢复患者步态平衡是临床治疗和护理的主要目标。……