Department of Nursing, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Xuhui District, Shanghai, China.
Department of Neurology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Xuhui District, Shanghai, China.
Brain Behav. 2023 Mar;13(3):e2890. doi: 10.1002/brb3.2890. Epub 2023 Feb 3.
Ischemic stroke is a clinical emergency caused by insufficient intracranial blood supply, which eventually leads to brain tissue necrosis and neurological impairment. Predictive nursing intervention has achieved impressive success in the nursing of multiple surgeries. However, the role of predictive nursing intervention in the care of patients with ischemic stroke remains unclear.
This study was a randomized controlled trial. Based on the inclusion and exclusion criteria, 126 patients were randomly assigned into two groups, namely the control group and the predictive nursing intervention group. Both groups were treated with thrombolytic therapy with alteplase. The patients in the control group were given routine nursing intervention and the predictive nursing intervention group received additional predictive care. Neurologic functions and cognitive impairment were evaluated by National Institutes of Health Stroke Scale (NIHSS), Fugl-Meyer assessment (FMA), Montreal cognitive assessment (MoCA), and mini-mental state examination (MMSE) scales, respectively. Door-to-Needle Times, venous thromboembolism (VTE)-related parameters, and complications were recorded.
Predictive nursing intervention significantly shortened the Door-to-Needle Times and enhanced the peak/average femoral venous blood flow and femoral venous diameter. In addition, predictive nursing intervention improved the NIHSS, FMA, MMSE, and MoCA scores and remarkably reduced the recurrence of ischemic stroke, deep vein thrombosis and gingival bleeding.
Predictive nursing intervention is beneficial to improve the effects of thrombolytic therapy in patients with ischemic stroke, which improves the neurological, cognitive and motor functions of patients, and reduces the occurrence of complications, suggesting an important clinical application value.
缺血性脑卒中是由颅内血液供应不足引起的临床急症,最终导致脑组织坏死和神经功能损伤。预测性护理干预在多种手术的护理中已取得显著成效。然而,预测性护理干预在缺血性脑卒中患者护理中的作用尚不清楚。
这是一项随机对照试验。根据纳入和排除标准,将 126 名患者随机分为对照组和预测性护理干预组。两组均接受重组组织型纤溶酶原激活物溶栓治疗。对照组给予常规护理干预,预测性护理干预组给予额外的预测性护理。采用美国国立卫生研究院卒中量表(NIHSS)、Fugl-Meyer 评估(FMA)、蒙特利尔认知评估(MoCA)和简易精神状态检查(MMSE)量表评估神经功能和认知障碍。记录门到针时间、静脉血栓栓塞(VTE)相关参数和并发症。
预测性护理干预显著缩短了门到针时间,提高了峰值/平均股静脉血流和股静脉直径。此外,预测性护理干预改善了 NIHSS、FMA、MMSE 和 MoCA 评分,显著降低了缺血性脑卒中、深静脉血栓形成和牙龈出血的复发率。
预测性护理干预有利于提高缺血性脑卒中患者溶栓治疗的效果,改善患者的神经、认知和运动功能,降低并发症的发生,提示其具有重要的临床应用价值。