强化护理干预对老年血管性痴呆患者功能恢复的影响

目的探讨强化护理干预对老年血管性痴呆的患者功能恢复的影响。方法将216例患者随机分为强化护理组（n=116）和一般护理组（n=100），一般护理组予常规护理，强化护理组在此基础上给予功能康复训练、心理障碍以及认知障碍的康复护理。比较护理干预前及干预4周后两组简易智力状态量表（MMSE）、长谷川痴呆量表（HDS）、临床痴呆量表（CDR）、韦氏记忆量表（WMS-RC）、Blessed痴呆量表（IMCT）、简式Fugl—Meyer运动功能评分法（FMA）、社会功能活动调查表（FAQ）和日常生活能力量表（ADL）的评分结果。结果4周末强化护理组患者MMSE评分（19．86±3．15），HDS评分（24．85±2．39），WMS-RC评分（62．24±8．71），IMCT评分（25．39±5．62）、FMA评分（68．71±14．18），ADL评分（67．39±14．29：），均高于一般护理组；CDR评分低于一般护理组，差异均有统计学意义（t=3．96，6．09，2．11，3．83，3．87，6．12，3．06，9．54；P〈0．01或P〈0．05）。强化护理组干预前后各项评分差异有统计学意义（P〈0．01），而一般护理组差异无统计学意义（P〉0．05）。结论综合康复训练能改善患者的认知功能和日常生活自理能力，延缓病情发展。

Effect of intensive nursing intervention on recovery function of elderly patients with vascular dementia

Objective To discuss the effect of intensive nursing intervention on elderly patients with vascular dementia. Methods 216 senile cases with vascular dementia were randomly divided into 2 groups:intensive nursing group (n =116) and control group (n =100). Intensive group received 4-week rehabilitation training. The Mini-Mental State Examination( MMSE), the Hasegawa' s dementia Scale (HDS), the Clinical Dementia Rating Scale ( CDR), the Wechsler memory scale-revised in China for Adult ( WMS-RC ), the Blessed Dementia Scale( information-memory-concentration test, IMCT), the Fugl-Meyer Assessment (FMA),the Functional Activities Questionnaire (FAQ) and the Activity of Daily Living Scale (ADL) were applied at the beginning of the treatment and at the end of 4 weeks to evaluate the cognitive function and daily living ability.Results Scores of MMSE (19.86±3. 15), HDS (24.85 ±2.39), WMS-RC (62.24±8.71), IMCT (25.39±5.62) , FMA (68.71 ± 14. 18) and ADL (67.39 ± 14.29) of the patients in both groups at the end of 4 weeks showed significant difference (t =3.96, 6.09, 2.11, 3.83, 3.87, 6. 12, 3.06,9.54, respectively, P＜0. 01 or P ＜0. 05) ; CDR and FAQ of intensive nursing group was significantly reduced (t =2. 98,9. 49;P ＜0. 01 ) while that of control group was of no obvious difference (P ＞0. 05) ; the score improvement of 8 kinds of figures before and after treatment in rehabilitation training group was much greater than that in control group (P ＜ 0. 05 ). Conclusions Rehabilitation training can obviously improve the cognition and daily living ability of the senile patients with vascular dementia and it can also delay the dementia progress.