林育微 罗世炜 黄少曼 郑丹兵

[摘要]目的探讨对机械取栓术治疗的急性脑梗死患者实施循证支持护理对其神经功能和负性情绪的影响。方法选取2019年1月至2020年1月揭陽市人民医院神经内三科收治的80例急性脑梗死患者进行研究，采用抛硬币随机分组的方式将病例分为试验组（ n=40）和对照组（ n=40）。两组均接受机械取栓术治疗，对照组实施围术期常规护理干预，试验组实施循证支持护理，比较两组的护理效果。结果试验组干预后的神经功能缺损评分（NIHSS）低于对照组，差异有统计学意义（ P <0.05）;试验组干预后的 SAS、SDS 评分均在正常标准值内且均低于对照组，差异有统计学意义（ P <0.05）;试验组患者护理总满意率为97.50%，高于对照组的82.50%，差异有统计学意义（ P <0.05）。结论机械取栓术是目前治疗急性脑梗死的有效手段，配合围术期循证支持护理可进一步改善患者的神经功能和负性情绪，同时该护理方案对和谐护患关系的建立有促进作用。

[关键词]急性脑梗死;机械取栓术;循证护理;神经功能;负性情绪

[中图分类号] R743.33  [文献标识码] A   [文章编号]2095-0616（2021）24-0122-04

Impacts of perioperative evidence-based support on neurological function and negative emotion of patients with acute cerebral infarction treated by mechanical thrombectomy

LIN  Yuwei    LUO  Shiwei    HUANG  Shaoman    ZHENG  Danbing

1.Department Ⅲ of Neurology， Jieyang People's Hospital， Guangdong， Jieyang 522000， China;2. Hospital Infection- Control Department， Jieyang People's Hospital， Guangdong， Jieyang 522000， China

[Abstract] Objective To investigate the impacts of evidence-based support nursing on neurological function and negative emotion of patients with acute cerebral infarction treated by mechanical thrombectomy. Methods A total of 80 patients with acute cerebral infarction admitted to and treated in the Department Ⅲ of Neurology of Jieyang People's Hospital from January 2019 to January 2020 were selected for research， and they were divided into the experimental group （n=40） and the control group （n=40） by the coin tossing random grouping method. Both groups were treated with mechanical thrombectomy， and the control group was treated with conventional perioperative nursing intervention， while the experimental group was treated with evidence-based support nursing. The nursing effects of the two groups were compared. Results After intervention， the score of NIHSS in the experimental group lower than that of the control group， with statistically significant difference （P <0.05）. After intervention， the SAS and SDS scores of the experimental group were within the normal standard values， and both scores were lower than those of the control group， with statistically significant differences （P <0.05）. The  total satisfaction rate of nursing service in patients of the experimental group was 97.50%， higher than 82.50% of the control group， with statistically significant difference （P <0.05）. Conclusion Mechanical thrombectomy is an effective method to treat acute cerebral infarction at present. Combined with evidence-based support nursing during perioperative period， it can further improve the neurological function and negative emotion of patients. At the same time， this nursing scheme can promote the establishment of harmonious nurse-patient relationship.

[Key words] Acute cerebral infarction; Mechanical thrombectomy; Evidence-based nursing; Neurological function; Negative emotion

急性脑梗死是由于脑部动脉血管粥样硬化引起血管腔狭窄、闭塞而导致脑部供血不足的脑血管疾病，约占脑卒中疾病的70%[1]。该疾病致死、致残率较高，临床上对该疾病的防治高度重视。从治疗角度看，颅内闭塞血管能否再通是决定急性脑梗死患者预后的关键。在符合静脉溶栓时间窗患者的治疗中，静脉溶栓药物治疗能够取得一定的治疗效果，但对时间窗的要求相对较高且患者术后出现各类相关并发症的可能性较大;同时静脉溶栓治疗大动脉闭塞的再通率也相对较低[2]。血管内机械取栓是近年来应用于临床的一种新型治疗手段，相对于静脉溶栓能够大幅度提升大血管闭塞的再通率，是一种安全可靠的治疗手段[3]。循证护理是基于患者的病情及现有科学研究所衍生的一种具有针对性的护理理念，能够有效规避患者在治疗和康复阶段的各类风险因素。……