摘要
目的探究佛山市社区老年阿尔茨海默病(AD)合并高尿酸血症(HUA)患者标准化护理程序效果评价。方法选取2017年6月至2018年5月在该院治疗、按照认知功能评估、年龄大于65岁AD合并HUA患者100例,采用随机数字表法随机分为试验组和对照组,各50例。对照组给予常规治疗护理及教育指导,试验组在此基础上由专科护士全面评估,制定并实施标准化护理程序,分别记录两组患者出院后1、3、6、12个月各个指标的变化。结果出院后,两组简易精神状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)、日常生活能力Barthel指数(BI)评分相较于住院时均有所改善,差异均有统计学意义(P<0.05),然而两组MoCA评分在出院后各个时间点比较,差异均无统计学意义(P>0.05)。两组MMSE、BI及用药依从性评分均有随时间变化的趋势(P时间<0.01),分组与时间有交互效应(P交互<0.01)。两组护理前各项危险因素控制均无差异,护理后两组指标均有一定程度的改善,且试验组血尿酸、三酰甘油(TG)、总胆固醇、低密度脂蛋白胆固醇(LDL-C)、同型半胱氨酸(Hcy)及舒张压改善情况均明显优于对照组,差异均有统计学意义(P<0.05)。单因素logistic回归分析显示,年龄、TG、高密度脂蛋白胆固醇(HDL-C)、LDL-C及Hcy是其独立危险因素(P<0.05),多因素logistic回归分析显示,TG、HDL-C、LDL-C及Hcy为护理效果的危险因子。结论针对社区老年AD合并HUA患者制定标准化护理程序并实施,将使患者极大地保持身体功能,延缓疾病的进展,减轻家庭和社会的负担。
Objective To evaluate the effect of standardized nursing procedures for elderly patients with Alzheimer′s disease(AD)complicated with hyperuricemia(HUA)in Foshan community.Methods A total of 100 patients over 65 years old with AD combined with HUA who were treated in the hospital from June 2017 to May 2018 according to the cognitive function assessment were selected.According to random number table method,they were randomly divided into the experimental group and the control group,with 50 cases in each.The control group was given routine treatment,nursing and educational guidance.On this basis,the experimental group was comprehensively evaluated by specialist nurses,and standardized nursing procedures were developed and implemented.The changes of each indicator in 1,3,6 and 12 months after discharge were recorded in the two groups.Results After discharge,two groups of mini-mental status examination scale(MMSE),Montreal cognitive assessment scale(MoCA),daily life ability Barthel index(BI)score compared with hospitalization were improved,the differences were statistical significance(P<0.05),however,two groups of MoCA scores at all time points after discharge,difference was no statistical difference(P>0.05).The MMSE,BI and medication compliance scores of the two groups all showed a trend of changing with time(P time<0.01),and there was an interaction between the groups and time(P interaction<0.01).Two groups of various risk factors control had no difference before nursing,after nursing in the two groups are improved to a certain extent,and the experimental group in blood uric acid,three acyl glycerin(TG),total cholesterol,low-density lipoprotein cholesterol(LDL-C),homocysteine(Hcy)and diastolic blood pressure to improve the situation was better than control group,difference was statistical significance(P<0.05).Unifactorial logistic regression analysis showed that age,TG,high-density lipoprotein cholesterol(HDL-C),LDL-C and Hcy were independent risk factors(P<0.05),while multivariate logistic regression analysis showed that TG,HDL-C,LDL-C and Hcy were risk factors for nursing effect.Conclusion The development and implementation of standardized nursing procedures for elderly patients with AD and HUA in the community will greatly maintain the physical function of the patients,delay the progress of the disease,and reduce the burden on the family and society.
作者
罗小英
邝素晶
林碧清
LUO Xiaoying;KUANG Sujing;LIN Biqing(Department of Neurology,Foshan First People′s Hospital,Foshan,Guangdong 528000,China)
出处
《现代医药卫生》
2020年第11期1650-1655,共6页
Journal of Modern Medicine & Health
