Model essay topic: analysis of early rehabilitation nursing for elderly patients with cerebral infarction
In recent years, although the success rate of rescuing cerebral infarction is increasing, the dysfunction left after cerebral infarction is still very serious, and the proportion of severe disability reaches 40%. From the perspective of brain plasticity and functional reorganization theory, early rehabilitation after cerebral infarction is of great significance to reduce the degree of disability of patients. Previous studies abroad have shown that patients who received rehabilitation intervention 7 days after stroke have significantly improved their long-term efficacy [1]. This paper discusses the influence of early rehabilitation nursing on the living ability of elderly patients with cerebral infarction, and the report is as follows.
1 objects and methods
1. 1 object. Eighty-six elderly patients with cerebral infarction from June 20 17 to July 20 18 in our hospital were selected, all of whom were newly diagnosed and had no previous history of disability or neurological dysfunction. 47 males and 39 females; The age ranged from 62 to 78 years with an average of (70.54 8.70) years. They were randomly divided into study group and control group. There were 43 cases in each group, and there was no significant difference in general data between the two groups. 1.2 method. The research group began rehabilitation nursing at 72 hours after cerebral infarction when the condition was stable, which mainly included: (1) early posture change to maintain the functional position of the affected limb. (2) Encourage patients to engage in joint activities in bed, and gradually start training in sitting, getting out of bed, standing and walking. (3) Instruct patients to carry out occupational therapy, including improving muscle strength and improving the stability of scapular girdle when flaccid; When spasticity occurs, the hands are crossed to hold strength training; Improve coordination and fine functions during the recovery period. (4) Encourage patients to read books, listen to music and play with small toys. , thus stimulating sensory perception and promoting the recovery of nerve function. Conduct training such as eating, dressing, washing, urinating and defecating, and choose some hobbies to cultivate interest in life. (5) At the same time of rehabilitation training, carry out targeted psychological intervention to improve patients' cooperation. The control group took delayed rehabilitation nursing, and the opportunity of rehabilitation nursing was 7 days after onset. 1.3 Observe the finger. FuglMeyer system was used to evaluate the improvement of motor function of patients, and Barthel index was used to evaluate the improvement of daily living ability of patients before and after nursing. 1.4 statistical method. SPSS 18.0 statistical software was used to analyze and process the data, and P < 0.05 showed that the difference was statistically significant.
Two results
Before nursing, the FuglMeyer score in the study group was (13.521.26) and the Barthel index was (40.24 3.29), while the FuglMeyer score in the control group was (/kloc-0 12.66±2.46) and the Barthel index was (39). After nursing, the FuglMeyer score in the study group was (24.551.40), the Barthel index was (52.15 4.77), and the FuglMeyer score in the control group was (18.55 2.10.
3 discussion
Almost 60%~80% of stroke patients belong to cerebral infarction. The formation of penumbra is a remarkable feature of cerebral infarction, but it has been found that neurons at this time are not necrosis, but conduction failure. With early intervention, these cells can return to normal. At present, there is still no uniform standard for the best time for early rehabilitation after cerebral infarction. Some scholars believe that early rehabilitation may lead to a series of complications such as aggravation of neurological deficit, recurrence of stroke and fall. [2], but AVERT research shows that it is safer to get out of bed within 24 hours after cerebral infarction, and the recent mortality rate will not increase compared with delayed activity [3]. Animal experiments show that early exercise can increase blood perfusion in ischemic cerebral cortex, reduce ischemic penumbra, protect brain tissue and improve memory, exercise and spatial learning ability. Weighing the advantages and disadvantages of early rehabilitation, the advantages should outweigh the disadvantages. At present, the timing of early intervention is mostly 48 ~ 72 hours after onset, and some people have proposed ultra-early activities, that is, getting out of bed within 24 hours after onset, but there is a lack of RCT research with large samples. Considering that the elderly patients in this study have many basic diseases, poor motor coordination ability and easy to fall down during activities, they began rehabilitation training 72 hours after onset. The results showed that the FuglMeyer score and Barthel index of the study group were significantly higher than those of the control group. Once again, it is proved that early rehabilitation nursing for elderly patients with cerebral infarction is safe and effective.
refer to
[1] Luo Juzhen, Yang Jinbiao, Wang Yanhong, et al. Effect of early rehabilitation nursing on the quality of life of patients with acute cerebral infarction [J]. China Journal of Modern Nursing, 20 1 1, 17 (4): 420-422.
[2] Li Chunhong. Effect of early emotional nursing on negative emotions and compliance of rehabilitation nursing in elderly patients with cerebral infarction [J]. Journal of Nurses' Continuing Education, 20 12, 17 (2): 147.
[3] Xu Shiying. Application of early systematic rehabilitation nursing in senile depression after acute cerebral infarction [J]. Journal of Liaoning University of Traditional Chinese Medicine, 2014,21(11):187-188.
Authors: Xiao Dan Setting: Fukuang General Hospital of Liaoning Health Industry Group.