Clinical effects of distal ischemic conditioning combined with early rehabilitation nursing in patients with spontaneous supratentorial intracerebral hemorrhage

WU Lin; CAO Weidong; SUN Junzhao; LEI Yifei; JIANG Zhantao; ZHAO Xiaohan; PI Hongying

doi:10.3639/j.issn.1671-2897.2025.03.023

Abstract：Objective To construct an intervention scheme combining remote ischemic conditioning(RIC)with early rehabilitation nursing(ERN)based on the theory of evidence-based nursing(hereinafter referred to as the"intervention scheme")and observe its clinical application effects in patients with spontaneous supratentorial intracerebral hemorrhage.Methods 120 patients with spontaneous supratentorial intracerebral hemorrhage admitted to the Department of Neurosurgery at the Sixth Medical Center of the PLA General Hospital from June 2023 to October 2024 were selected.The enrolled patients were randomly divided into a RIC group,an ERN group,and a RIC+ERN group.On the basis of routine treatment and nursing for the three groups of patients,the RIC group received remote ischemic conditioning treatment,the ERN group received early rehabilitation nursing,and the RIC+ERN group received a combination of remote ischemic conditioning and early rehabilitation nursing.The intervention had lasted for 14 days,with follow-up until 90 days after enrollment.The NHISS score(National Institutes of Health Stroke Scale)and BI index score(Barthel Index BI,daily living self-care ability score sheet)of the three groups of patients were compared at the time of enrollment,14 days after intervention,and 90 days after enrollment.Results Fifteen patients dropped out of the study due to reasons such as automatic discharge and transfer to other departments,and finally 105 patients were included in the study,with 36 patients in the RIC group,37 patients in the ERN group,and 32 patients in the RIC+ERN group.Analysis of the variance showed that there were time and group interaction effects on NHISS score and BI index score in the three groups of patients(NHISS score:Finteraction=14.095,Pinteraction<0.001;BI index score:Finteraction=20.284,Pinteraction<0.001).Further pairwise comparison analysis showed that on the 14th day of intervention and 90 days after enrollment,the NHISS score of the RIC+ERN group was lower than that of the RIC group and ERN group,and its BI index score was higher than that of the RIC group and ERN group(P<0.05).Conclusions The integrated intervention plan of remote ischemic preconditioning combined with early rehabilitation nursing combines the advantages of both methods,promotes the improvement of the condition of patients with spontaneous supratentorial intracerebral hemorrhage,effectively improves the patient's neurological function and self-care ability,and improves the patient's rehabilitation outcome.The effect is better than that of implementing remote ischemic preconditioning treatment and early rehabilitation nursing alone.