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中华实验和临床感染病杂志(电子版)

中华实验和临床感染病杂志(电子版) ›› 2016, Vol. 10 ›› Issue (05) : 614 -618. doi: 10.3877/cma.j.issn.1674-1358.2016.05.022

短篇论著

脑卒中单侧空间忽略患者并发坠积性肺炎的相关因素分析及综合干预效果评价
彭洋1, 蒋艳玲2, 吴修慧3, 陈丹丹4,†()   
  1. 1. 448000　荆门，湖北省荆门市第一人民医院消化内科
    2. 833300　精河县，新疆维吾尔自治区博尔塔拉蒙古族自治州精河县人民医院内科
    3. 448000　荆门，湖北省荆门市第一人民医院神经康复科
    4. 448000　荆门，湖北省荆门市第一人民医院普外科
  • 收稿日期:2015-06-14 出版日期:2016-10-15
  • 通信作者: 陈丹丹

Comprehensive management of intervention to unilateral spatial neglection and hypostatic pneumonia of patients with stroke

Yang Peng1, Yanyan Jiang2, Xiuhui Wu3, Dandan Chen4,†()   

  1. 1. Department of GastroenterologyThe First People’s Hospital of Jingmen, Jingmen 448000, China
    2. Department of Internal Medicine, Renmin Hospital in Jinghe Tara Mongolian Autonomous Prefecture County of Xinjiang Uygur Autonomous Region, Jinghe 833300, China
    3. Department of RehabilitationThe First People’s Hospital of Jingmen, Jingmen 448000, China
    4. Department of General Surgery, The First People’s Hospital of Jingmen, Jingmen 448000, China
  • Received:2015-06-14 Published:2016-10-15
  • Corresponding author: Dandan Chen
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彭洋, 蒋艳玲, 吴修慧, 陈丹丹. 脑卒中单侧空间忽略患者并发坠积性肺炎的相关因素分析及综合干预效果评价[J]. 中华实验和临床感染病杂志(电子版), 2016, 10(05): 614-618.

Yang Peng, Yanyan Jiang, Xiuhui Wu, Dandan Chen. Comprehensive management of intervention to unilateral spatial neglection and hypostatic pneumonia of patients with stroke[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2016, 10(05): 614-618.

目的

评价住院早期对脑卒中单侧空间忽略（USN）患者进行综合性的管理与干预的效果。

方法

收集入住本院的40例USN患者，随机分为即观察组和对照组，每组患者各20例。对照组患者按照传统的常规管理联合雾化吸入；而观察组患者则在此基础上由单侧空间忽略小组进行综合管理干预联合雾化吸入。

结果

单侧空间忽略综合管理小组经过对观察组患者进行干预后，与对照组比较，发现观察组患者CBIT和MBI均存有一定的优势（CBIT：17.41±18.17 vs. 31.75±16.33，t = 2.625、P = 0.01；MBI：85.38±14.25 vs. 71.49±11.12，t = 3.437、P = 0.002）。观察组患者（综合管理干预后）坠积性肺炎发生率仅为6.67%，较对照组33.3%低，差异具有统计学意义（χ2= 9.62、P = 0.01），且管理满意率亦显著高于对照组（χ2= 6.36、P = 0.001），观察组患者治愈率和好转率分别为70.00%和25.00%，显著高于对照组的40.00%和15.00%，差异具有统计学意义（χ2= 7.16、P = 0.012，χ2= 6.02，P = 0.01）。

结论

住院早期对脑卒中单侧空间忽略患者实施综合管理干预，可有效地减轻患者单侧空间忽略的程度及长期卧床导致的坠积性肺炎发生率，有利于大大增强患者的生活自理能力，改善患者的生活质量。

关键词: 住院早期, 综合管理干预, 脑卒中, 单侧空间忽略.
Objective

To evaluate the effect of the comprehensive management and intervention for stroke patients with unilateral spatial neglect (USN) during the early hospitalization.

Methods

Total of 40 hospitalized patients with USN were selected and randomly divided into the control group and the observation group, with 20 cases in each group. The patients in control group received the routine management conventional conbines aerosol inhalation; on this basis, while the patients in observation group were taken comprehensive management by the unilateral spatial neglect team.

Results

After the intervention of comprehensive management team of USN, the CBIT and MBI of patients in observation group were better than those of the control group (CBIT: 17.41±18.17 vs. 31.75±16.33; t = 2.625, P = 0.01. MBI: 85.38±14.25 vs. 71.49±11.12; t = 3.437, P = 0.002). The integrated management of patients in intervention group after the hypostatic pneumonia incidence rate was only 6.67%, significantly lower than that of the control group (33.3%), with significant difference (χ2= 9.62, P = 0.01). The management satisfaction was significantly higher than that of control group (χ2= 6.36, P = 0.001). The cure rate and the recovery of pateints in observation group were 70.00% and 25.00%, significantly higher than those of the control group (40.00% and 15.00%), with significant differences (χ2= 7.16, P = 0.012; χ2= 6.02, P = 0.01).

Conclusions

In the early days of hospitalization, the comprehensive management intervention for stroke patients with USN, had effectively reduced the degree of the patients with USN and leaded to long-term stay in bed and then hypostatic pneumonia incidence, with could greatly improve the self-care ability of the patient’s life, and improve the quality of life.

Key words: Early hospitalized, Comprehensive management intervention, Stroke, Unilateral spatial neglect.
表1 住院早期管理干预前后两组患者的CBIT和MBI评分（±s，分）
组别 例数 CBIT MBI
干预前 干预后 干预前 干预后
观察组 20 87.55±56.87 17.41±18.17 24.00±4.01 85.38±14.25
对照组 20 89.23±57.36 31.75±16.33 24.36±4.31 71.49±11.12
t值   0.093 2.625 0.267 3.437
P值   0.927 0.010 0.791 0.002
表2 两组患者治疗早期的评价比较情况分析
分组 例数 非常满意 基本满意 不满意 满意率（%）
观察组 20 12 5 3 85.00
对照组 20 4 7 9 59.09
表3 两组患者的预后情况[例（%）]
分组 例数 治愈 好转 死亡
观察组 20 14（70.00） 5（25.00） 1（8.82）
对照组 20 8（40.00） 3（15.00） 9（45.00）
χ2值   7.160 6.020 7.080
P值   0.012 0.010 0.020
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