Effect of nursing case management on early clinical efficacy for acute ischemic stroke patients with thrombolytic therapy
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摘要:目的 探讨护理个案管理对急性缺血性脑卒中患者溶栓治疗早期临床效果的影响。方法 将80例接受溶栓治疗的急性缺血性脑卒中患者随机分为2组，对照组采用常规护理，实验组采用护理个案管理护理模式。统计患者从入院到接受溶栓治疗的时间，采用美国国立卫生研究院卒中量表(NIHSS)对溶栓治疗前后24 h患者的神经功能缺损程度进行评分，比较2组间的差异。结果 实验组从入院到接受溶栓治疗的时间为(34.22±4.83) min, 显著短于对照组的(70.56±7.68) min(P < 0.05)。2组患者溶栓治疗前的NIHSS评分无显著差异(P > 0.05); 治疗后24 h, 实验组的NIHSS评分较治疗前和对照组均显著降低(P < 0.05), 但对照组的NIHSS评分较治疗前改善不显著(P > 0.05)。结论 护理个案管理有助于提高急性缺血性脑卒中患者溶栓治疗的早期临床效果。Abstract:Objective To explore the effect of nursing case management on early clinical efficacy for acute stroke patients with thrombolytic therapy.Methods A total of 80 patients with acute ischemic stroke who received thrombolytic therapy were randomly divided into two groups. Control group received routine nursing and experimental group received case management nursing. The time from admission to thrombolytic therapy was recorded. National Institutes of Health Stroke Scale (NIHSS) scores before and after 24 h of thrombolytic therapy in two groups were compared.Results The time from admission to thrombolysis was (34.22±4.83) min in the experimental group, which was significantly less than (70.56±7.68) min in the control group(P < 0.05). There was no significant difference in NIHSS score between the two groups before thrombolytic therapy(P > 0.05). At 24 h after treatment, the NIHSS score in the experimental group was significantly lower than treatment before and the control group (P < 0.05), but the control group showed no significant improvement compared to treatment before (P > 0.05).Conclusion Nursing case management is helpful for improving the early clinical effect of thrombolytic therapy in patients with acute ischemic stroke.
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表 1 2组患者从入院到接受溶栓治疗的时间比较(x±s)[n(%)]
组别 n 0~30 min >30~60 min >60~90 min >90~120 min 平均用时/min 对照组 40 2(5.00) 10(25.00) 25(62.50) 3(7.50) 70.56±7.68 实验组 40 17(42.50)* 20(50.00)* 2(5.00)* 1(2.50) 34.22±4.83* 与对照组比较, *P < 0.05 
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表 2 2组患者治疗前后NIHSS评分比较(x±s)
分 组别 n 治疗前 治疗后24 h 对照组 40 14.16±6.65 11.23±7.21 实验组 40 13.33±6.52 6.68±5.14*# 与对照组比较, #P < 0.05
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