Construction and application of an evidence-based practice plan for early activity in postoperative patients with cerebral infarction / 中国实用护理杂志

ABSTRACT

Objective:To explore the construction and application of an evidence-based practice plan for early postoperative activity in postoperative patients with large area cerebral infarction.Methods:Ninety-six postoperative patients with large area cerebral infarction admitted to Wenzhou Central Hospital from July 2021 to April 2023 were selected as the study subjects for a Clinical trial. They were divided into the control group (48 cases) and the observation group (48 cases) by random number table method. The control group received routine postoperative care for neurosurgery, while the observation group received evidence-based systematic early activity training. Both groups were followed up until 1 month after the patient was discharged from the hospital. The time of postoperative hospitalization, hospitalization expenses, vital signs and pain investigation 48 h after surgery, daily living ability before intervention and 7 d, 1 month after discharge, neurological function before intervention and 7 d and 1 month after surgery, and complications during follow-up between the two groups were compared.Results:In the control group, there were 29 males and 19 females, with an average age of 43-67(56.87 ± 1.76) years. In the observation group, there were 31 males and 17 females, with an average age of 43-68 (57.02 ± 1.82) years. The postoperative hospital stay in the observation group was (6.87 ± 0.65) d, in the control group was (9.06 ± 0.72) d, the difference between them was significant ( t=15.64, P<0.05). 48 hours after surgery, the heart rate, breathing rate and mean arterial pressure in the observation group were (71.65 ± 0, 45) times/min, (14.76 ± 0.36) times/min and (76.98 ± 5.65) mmHg(1 mmHg=0.133 kPa), which were different with those in the control group, (82.76 ± 2.65) times/min, (18.76 ± 2.87) times/min and (93.76 ± 5.93) mmHg ( t=28.64, 9.58 and 14.19, all P<0.05). Seven days after discharge, the score of Activities of Daily Living and the National Institutes of Health Neurological Impairment Scale in the observation group were (84.65 ± 2.45) and (23.65 ± 2.65), which were different than the (79.76 ± 1.97) and (28.54 ± 2.73) in the control group ( t=10.26, 8.91, both P<0.05). A month after discharge, the score of Activities of Daily Living and the National Institutes of Health Neurological Impairment Scale in the observation group were (95.45 ± 1.43) and (18.65 ± 1.98), while in the control group were (87.87 ± 1.39) and (21.54 ± 2.76), the difference between them were significant ( t=26.33, 5.90, both P<0.05). The total incidence of complications such as postoperative bleeding, postoperative infection and hypoxemia in the observation group was 20.83% (10/48), which was significant lower than the 68.75% (33/48) in the control group ( χ2=22.28, P<0.05). Conclusions:Evidence-based systematic early activity training could significantly alleviate postoperative pain in patients with large area cerebral infarction after surgery, improve their daily living ability and neurological function, further effectively shorten their hospitalization time, and reduce the occurrence of complications.