中西医结合卒中单元急性脑卒中临床护理路径应用研究

目的研究中西医结合卒中单元急性脑卒中的临床护理路径。方法将120例急性脑卒中患者分成2组，观察组60例，实施中西医结合临床护理路径，对照组60例，采用传统护理方法。2组患者均在入院时及治疗15天、30天、45天、60天时进行神经功能缺损评分（NIHSS）、日常生活能力评定（Barthel指数），在出院时进行并发症以及卫生经济学评定，并调查患者满意度。结果2组患者入院时NIHSS评分及Barthel指数无统计学差异（P〉0．05）；入院45天及60天，观察组NIHSS评分低于对照组，Barthel指数高于对照组，差异均有统计学意义（P〈0．05）。观察组与对照组在药费、康复护理费用、NIHSS减少及Barthel指数增加值等方面差异具有统计学意义（P〈0．05）；在总费用方面差异无统计学意义（P〉0．05）。观察组并发症的发生率低于对照组，满意度高于对照组，差异有统计学意义（P〈0．05）。结论对中西医结合卒中单元急性脑卒中患者采用规范的临床护理路径是取得良好预后的重要保证。

A study of the application of clinical nursing pathways in stroke unit with integrated traditional Chinese and Western medicine in the treatment of acute stroke

Objective To investigate the feasible clinical nursing pathways of stroke unit of integrated traditional Chinese and Western medicine in patients with acute stroke. Methods 120 patients with acute stroke were divided into 2 groups （n = 60 each） ： the observation group with the clinical nursing pathway of integrated Chinese and Western medicine and the control group with conventional clinical nursing pathway, The patients in both groups underwent evaluations by The National Institutes of Health Stroke Scale （NIHSS） and Barthel＇s Index of Activities of Daily Living （BI） on the day of admission and 15, 30, 45 and 60 days of treatment and nursing care and assessment of complications and health economics as well as the satisfaction survey at discharge from hospital. Results There were no statistical differences in NIHSS and BI （ P 〉 0.05 ） between the two groups ; 45 and 60 days after admission, the observation group had lower NIHSS and higher BI than the control group, with differences of statistical significance （ P 〈 0.05 ）. Between the two groups, there were statistical differences in the expenses of medication and rehabilitation nursing, reduction of NIHSS and increase in BI （P 〈 0.05 ） ; there was no statistical difference in the total expenses. The observation group had lower incidence rate of complications and higher satisfaction degree than the control group （ P 〈 0.05 ）. Conclusion Normative clinical nursing pathway of stroke unit of integrated traditional Chinese and Western medicine is the key to the good prognosis of patients with acute stroke.