认知护理在脑梗死后抑郁症患者护理中应用研究.docVIP

认知护理在脑梗死后抑郁症患者护理中应用研究 　　[摘要] 目的 探讨认知护理干预对脑卒中后抑郁症患者神经和认知功能的影响。 方法 选取2010年12月～ 2014年6月我院中医科收治的120例患者随机分为两组各60例，对照组采取常规护理，观察组在此基础上配合认知护理，比较两组患者在护理前后HAMD、SDS、HAMA、Barthel积分的变化情况。 结果 治疗组在认知护理干预后平均HAMD、SDS和HAMA积分较治疗前和对照组明显降低（P0.05）。治疗组总有效率为90.0%，与对照组（78.3%）比较差异有统计学意义（P0.05）。 结论 认知护理干预能明显改善PSD患者心理状态，抑郁症状，促进神经功能恢复，值得推广应用。 　　[关键词] 脑梗死后抑郁症；认知护理；神经功能 　　[中图分类号] R473.74 [文献标识码] B [文章编号] 2095-0616（2015）19-141-03 　　[Abstract] Objective To study the effect of nerve and cognitive function of cognitive nursing intervention in patients with post-stroke depression. Methods 120 patients with depression after cerebral infarction were divided into control group which was adopted by routine nursing and observation group which was adopted by cognitive nursing based on routine nursing. To compare the integral changes of HAMD， SDS， HAMA， Barthel pre and post nursing between the two groups. Results The average integral of HAMD， SDS， HAMA in observation group after cognitive nursing intervention were obviously decreased than which before treatment， and which in observation group were obviously decreased than which in control group（P0.05）. The differences of total effective rate was statistical significance compared with observation group（90.0%） and control group（78.3%）（P0.05）. Conclusion Cognitive nursing intervention could obviously improve the psychological state and depressive symptoms in patients PSD， could promote neural functional recovery， is worthy of clinical application. 　　[Key words] Depression after cerebral infarction； Cognitive nursing； Nerve function 　　脑梗死后抑郁症（post-stroke depression，PSD）是脑梗死患者后期常见的并发症之一，抑郁症状不仅仅会使患者的精神痛苦进一步加重，可减缓患者神经功能恢复，加重患者认知功能障碍[1-4]。本研究观察了认知护理干预对脑梗死患者抑郁症状、神经和认知功能障碍的改善情况，现报道如下。 　　1 资料与方法 　　1.1 一般资料 　　观察2010年12月～2014年6月我院中医科收治的120例脑梗死后抑郁症患者为研究对象。纳入标准：所有病例均符合第四届脑血管疾病学术会议中制定的脑梗死诊断标准[5] 和中国精神疾病分类与诊断标准（CCMD-3）中抑郁症的诊断标准[6]。排除标准：（1）双向情感障碍抑郁相患者；（2）排除病前精神障碍和痴呆患者，有严重心、肺、肝、肾病变者。按数字随机化法将其分成两组，对照组60例，男28例，女32例，年龄58～72岁，平均（64.2±3.2）岁，病程1～5个月，平均（3.2±1.2）个月；观察组48例，男3