优质护理对颅脑外伤患者血糖、血脂变化的影响  

Effects of high quality nursing on blood glucose and blood lipid changes in patients with craniocerebral trauma

作　　者：卢斌华[1] 邵盼[1] 童民锋[1] 

机构地区：[1]浙江大学附属金华医院神经外科二区,浙江金华321000

出　　处：《中国医药导报》2014年第34期105-108,共4页China Medical Herald

基　　金：浙江省科技计划项目(编号2013C33103)

摘　　要：目的探讨优质护理方案对颅脑外伤患者的血糖、血脂的效果。方法选取浙江大学附属金华医院脑外科收治的颅脑外伤患者81例,将其分为两组,其中对照组41例参照颅脑外伤基础护理指南,给予常规脑外科护理方案：入院后评估伤情,无手术指征者,在神经外科监护室（NICU）救治,密切观察病情变化。需手术者术后送入NICU,进行多系统综合监护,即患者平卧位或头部抬高15°-30°卧位,促进脑部静脉回流,减轻脑水肿;头偏向一侧,防止舌后坠或呕吐物阻塞呼吸道;及时清除口腔和呼吸道内分泌物、呕吐物等;吸痰并避免肺内感染;给予连续监测颅内压（ICP）、脑灌注压（CPP）、动脉血氧分压（Pa O2）、心电图、脉搏氧饱和度（Sp O2）。实验组40例,在对照组基础上给予全面优质的护理方案,日间每2小时对患者进行个体化运动方案,控制血糖、血脂,1个月为1个疗程,治疗3个疗程。疗程结束后,对比两组患者血糖及血脂的变化情况。结果①治疗后,实验组血清总胆固醇[（4.7±0.8）mmol/L]、三酰甘油[（1.7±0.9）mmol/L]较对照组血清总胆固醇[（7.2±1.1）mmol/L]、三酰甘油[（3.2±1.2）mmol/L]明显下降,差异均有统计学意义（均P〈0.05）;②治疗后,实验组空腹血糖[（7.4±1.1）mmol/L]较对照组空腹血糖[（12.7±1.7）mmol/L]明显下降,差异有统计学意义（P〈0.05）。结论对颅脑外伤患者进行优质护理方案,可降低患者血糖及血脂的水平,对临床具有指导意义,值得临床推广。Objective To investigate the effect of high quality nursing on blood glucose and blood lipid changes in patients with craniocerebral trauma. Methods 81 patients with traumatic brain injury admitted to the Department of Cerebral Surgery of Jinhua Hospital Affiliated to Zhejiang University were selected, and divided into two groups, 41 cases of which for the control group with reference to basic nursing guide craniocerebral trauma, were given conventional cerebral surgery department nursing program： evaluation of trauma after admission; no operation indications in neurosurgery department ICU（NICU） treatment, close observation of the disease changes. Those who needed operation were sent into NICU after operation with comprehensive monitoring system： the patients were given supine or head elevation for 15degrees-30 degrees lie, promoting brain venous reflux, reducing brain edema; head to one side, preventing glossoptosis or vomit obstructive respiratory tract; the timely removal of secretions, vomit oral and respiratory tract sputum suction and avoid etc.; lung infection; including continuous monitoring of intracranial pressure（ICP）, cerebral perfusion pressure（CPP）, arterial partial pressure of oxygen（Pa O2）, ECG, pulse oxygen saturation（Sp O2）. 40 cases in the experiment group were given comprehensive quality of nursing program on the basis of the control group, every 2 h on the day patients for individualized exercise programs, control of blood glucose, blood lipid, one month was one course of treatment, treatment for 3 courses. After treatment, the changes of blood glucose and blood lipid of the two groups were compared. Results ① After treatment, the serum levels of total cholestero l and triglycerides in experimental group[（4.7±0.8）,（1.7±0.9） mmol/L] were significantly lower than those in the control group [（7.2±1.1）,（3.2±1.2） mmol/L], differences were statistically significant（all P〈0.05）; ②after treatment, the fasting glucose in experiment group [（7.4±1

关 键 词：优质护理 颅脑外伤 凝血功能 血糖 血脂 

分 类 号：R473.6[医药卫生—护理学]