多模式运动方案对多发腔隙性脑梗死后血管性痴呆患者的干预效果评价-现代医学

多模式运动方案对多发腔隙性脑梗死后血管性痴呆患者的干预效果评价

单位：南京市中心医院老年科, 江苏南京 210000

分类号：R473.5

出版年·卷·期（页码）：2025·53·第三期（348-356）

摘要：

目的：探讨多模式运动方案对多发腔隙性脑梗死(MLI)后血管性痴呆患者的干预效果，为进一步研究运动干预对改善MLI后血管性痴呆患者认知功能、运动能力和生活质量的作用提供科学依据。方法：纳入本院2021年6月至2024年1月期间住院的208例MLI后血管性痴呆患者，将患者随机分为干预组与对照组，每组104例。对照组实施常规护理，干预组在常规护理基础上实施基于证据总结和综合学科意见的多模式运动方案。干预4周后，对两组患者干预前后的平衡能力、运动耐力、运动依从性、生活质量、离床运动情况以及心理状态进行比较。结果：共有196例MLI后血管性痴呆患者完成研究，其中干预组97例、对照组99例。干预前，两组患者平衡能力、运动耐力、运动依从性、生活质量评分以及各心理状态评分差异均无统计学意义(均P＞0.05)。干预后，干预组患者平衡能力、运动耐力、运动依从性及生活质量评分均优于对照组；离床活动后摔倒、肌力分级≤4级的患者比例少于对照组(均P＜0.05)。另外，干预组患者的运动恐惧评分、焦虑评分以及抑郁评分均低于对照组(均P＜0.05)。结论：在MLI后血管性痴呆患者中应用多模式运动方案，有助于改善其运动功能、生活质量以及心理状态，对护理实践具有一定意义。

Objective: Exploring interventional effect of a multimodal exercise program for patients with vascular dementia after multiple lacunar infarctions(MLI), and to provide scientific evidence for further research on the effects of exercise intervention on improving cognitive function, motor ability and quality of life in patients with vascular dementia after MLI. Methods: A total of 208 patients with vascular dementia after MLI who were hospitalized in our hospital from June 2021 to January 2024 were included and randomly divided into an intervention group and control group, and 104 cases in each group. The control group received routine care, while the intervention group implemented a multimodal exercise program based on a review of evidence and multidisciplinary consensus in addition to routine care. Four weeks after the intervention, the balance ability, exercise endurance, exercise adherence, quality of life, out-of-bed activity and psychological status were compared between the two groups before and after the intervention. Results: A total of 196 vascular dementia patients after MLI completed the study, with 97 patients in the intervention group and 99 patients in the control group. Before the intervention, there were no statistically significant differences between the two groups in balance ability, exercise endurance, exercise adherence, quality of life scores, and psychological state scores(all P>0.05). After the intervention, the intervention group showed better balance ability, exercise endurance performance, exercise adherence, and quality of life scores than the control group, and a lower proportion of patients with falls after out-of-bed activities and muscle strength grades ≤4 compared to the control group(all P<0.05). Additionally, the intervention group had lower scores for exercise fear, anxiety, and depression compared to the control group(all P<0.05). Conclusion: The application of a multi-modal exercise program in patients with vascular dementia after MLI helps improve their exercise function, quality of life, and psychological state, which holds significant value for nursing practice.

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