多感官促醒刺激模式对高血压脑出血后昏迷患者觉醒意识及神经功能影响  

Effect of multi-sensory wake-up stimulation mode on the wakefulness and nerve function of comatose patients after hypertensive cerebral hemorrhage

作　　者：朱利华 程欣 赵莹莹 ZHU Li-hua;CHENG Xin;ZHAO Ying-ying(Department of Critical Care Medicine,Third People's Hospital of Zhengzhou City,Zhengzhou 450000,China)

机构地区：[1]郑州市第三人民医院重症医学科,河南郑州450000

出　　处：《社区医学杂志》2022年第17期979-983,共5页Journal Of Community Medicine

摘　　要：目的探讨高血压脑出血后昏迷患者采用多感官促醒刺激模式对其神经功能及觉醒意识的影响。方法选取2019-03-10-2021-03-10郑州市第三人民医院重症医学科收治的109例高血压脑出血后昏迷患者作为研究对象,采用随机数字表法进行分组,对照组54例给予常规干预,观察组55例在对照组基础上增加多感官促醒刺激模式,对比2组患者觉醒情况、神经功能、神经递质水平。结果干预后,观察组患者1~7 d、8~14 d的觉醒率分别为29.09%、54.55%,均高于对照组的12.96%、40.74%;15~30 d的觉醒率为16.36%,低于对照组的46.30%,差异有统计学意义,Z=3.382,P=0.001。观察组平均觉醒时间为(16.84±2.23)d,低于对照组的(24.15±3.42)d,差异有统计学意义,t=13.242,P<0.001。干预后,观察组格拉斯哥昏迷指数(GCS)评分、脑功能评分分别为(10.57±2.04)、(9.59±2.33)分,均高于对照组的(8.24±2.13)、(6.88±2.08)分,F值分别为5.833、6.402,均P<0.001;功能障碍评分量表(DFS)评分为(6.58±1.92)分,低于对照组的(9.24±2.31)分,F=6.543,P<0.001。观察组乙酰胆碱(ACh)、去甲肾上腺素(NE)、多巴胺(DA)水平分别为(197.43±17.54)、(628.44±65.65)、(3.51±0.80)ng/mL,均高于对照组的(157.22±17.32)、(511.34±64.22)、(2.58±0.68)ng/mL,F值分别为5.833、6.402、6.543,均P<0.001。结论多感官促醒刺激模式对高血压脑出血后昏迷患者效果确切,能够有效促进患者觉醒,提高神经功能和神经递质水平。Objective To study the effects of multi-sensory stimulation on neurological function and awakening consciousness of patients in coma after hypertensive intracerebral hemorrhage.Methods A total of 109 patients in coma after hypertensive intracerebral hemorrhage in the Department of Intensive Care Medicine of The Third People’s Hospital of Zhengzhou from March 10,2019 to March 10,2021 were selected as the research objects and divided into groups by random number table method.54 patients in the control group were given routine intervention,and 55 patients in the observation group were given multi-sensory stimulation mode on the basis of the control group.The awakening,neurological function and neurotransmitter levels of the two groups were compared.Results After intervention,the awakening rate of the observation group was 29.09%and 54.55%on 1-7 d and 8-14 d respectively,higher than 12.96%and 40.74%in the control group.The awakening rate on 15-30 d was 16.36%,lower than 46.30%in the control group,the difference was statistically significant(Z=3.382,P=0.001).The average awakening time of the observation group was(16.84±2.23)d,lower than that of the control group(24.15±3.42)d,and the difference was statistically significant(t=13.242,P<0.001).After intervention,the Glasgow coma index(GCS)score and brain function score of the observation group were(10.57±2.04)and(9.59±2.33)respectively,which were higher than those of the control group(8.24±2.13)and(6.88±2.08).The DFS score of the observation group after intervention was(6.58±1.92)points,lower than that of the control group(9.24±2.31)points,the difference was statistically significant(F=5.833,6.402,6.543,all P<0.001).The levels of ACh,NE and DA in the observation group were(197.43±17.54)ng/ml,(628.44±65.65)ng/ml and(3.51±0.80)ng/ml,respectively,higher than those in the control group(157.22±17.32)ng/ml,(511.34±64.22)ng/ml,(2.58±0.68)ng/ml,the difference was statistically significant(F=5.833,6.402,6.543,all P<0.001).Conclusion The multi-sensory stimulation m

关 键 词：四感联合促醒干预 昏迷 神经递质 高血压性脑出血 多巴胺 

分 类 号：R473.74[医药卫生—护理学]