早期中西医结合康复护理在脑卒中偏瘫患者中的应用

[摘要] 目的 探讨早期中西医结合康复护理在脑卒中偏瘫患者中应用的临床意义。 方法 对收治的232例脑卒中偏瘫患者在常规专科治疗及内科护理的基础上，采用了包括护理、肢体功能训练、中医药物护理、情志护理、生活起居护理及饮食调护在内的早期中西医结合康复护理，并在患者入院后第3天和住院40 d后进行Barthel指数评定。 结果 232例患者入院后第3天Barthel指数为（40.2±4.8）分，住院40 d天后评定为（76.3±10.2）分，日常生活活动能力有显著改善。 结论 早期中西医结合康复护理使康复训练的效应叠加，促进患者早日回归社会。

[关键词] 脑卒中；中西医结合；早期康复护理

[中图分类号] R49 [文献标识码] C [文章编号] 1673-7210（2012）07（a）-0137-02

Application of early rehabilitation nursing combined with traditional chinese medicine and western medicine in patients with stroke induced hemiplegia

LIU Xiaohong

Department of Encephalopathy, Beihai Hospital of Traditional Chinese Medicine, Guangxi Zhuang Autonomous Region, Beihai 536000, China

[Abstract] Objective To investigate the clinical significance of early rehabilitation nursing combined with traditional Chinese medicine and western medicine in the application of patients with stroke induced hemiplegia. Methods A total of 232 patients with stroke induced hemiplegia admitted to and hospitalized in our hospital were given early rehabilitation nursing combined with traditional Chinese medicine and western medicine, including postural nursing, limb function training, Chinese drug nursing, emotional nursing, daily life nursing and diet nursing on the basis of routine specialist treatment and internal medicine nursing. Barthel index evaluation was carried out in the 3 days after admission and 40 days of hospitalization. Results The Barthel index was (40.2±4.8) points in the 3 days after admission and (76.3±10.2) points in the 40 days of hospitalization. Daily living activity ability significantly improved. Conclusion Early rehabilitation nursing combining traditional Chinese medicine and western medicine has synergistic effects on rehabilitation training, which can promote patients' early return to society.

[Keywords] Stroke; Combining traditional Chinese medicine and western medicine; Early rehabilitation nursing

脑卒中又称中风或脑血管意外，是一组以急性起病、局灶性或弥漫性脑功能缺失为共同特征的脑血管疾病，主要表现以偏瘫最为常见，严重影响患者的生存质量。近年来，我们在常规专科治疗及内科护理的基础上，根据中医整体观念和辩证施护原则，整合现代康复技术，对我院住院的脑卒中患者采用早期中西医结合康复护理，取得较满意的效果。现报道如下：

1 资料与方法

1.1 一般资料

选取2009年10月～2011年9月在我院脑病科住院的脑卒中患者232例，均为发病后3 d内入院，符合1995年全国第4届脑血管病学术会议制订的脑血管病的诊断标准[1]，经头颅CT或MRI确诊。其中，男127例，女105例；年龄41～83岁；脑出血86例，脑梗死146例；肌力0级者32例，1级者76例，2级者81例，2～3级者43例。排除有严重的认知功能障碍的患者。

1.2 方法

按专科诊疗常规给予中西医结合治疗，脑出血以降低颅内压、调控血压和营养脑细胞治疗；脑梗死以抗血小板凝集、抗凝及改善脑循环治疗；有高血压、糖尿病及合并肺部感染者，分别予调控血压、控制血糖及抗感染治疗，配合针灸、穴位注射、自拟软瘫方及硬瘫方中药行瘫痪肢体药熨治疗。

1.3 护理