康复期护理对脑损伤患者并发激越情绪行为的影响  

Effects of rehabilitation nursing on agitation behavior of patients with traumatic brain injury

作　　者：王文红 费智敏[2] 张雅萍[3] 陈佳[1] 吴瑛[4] WANG Wenhong;FEI Zhimin;ZHANG Yaping(Emergency Department,Shanghai Shuguang Hospital Affiliated to Shanghai TCM University,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属曙光医院东院急诊科,201203 [2]上海中医药大学附属曙光医院东院脑外科,201203 [3]上海中医药大学附属曙光医院东院ICU,201203 [4]上海市第六人民医院脑外科

出　　处：《河北医药》2018年第23期3648-3652,共5页Hebei Medical Journal

摘　　要：目的分析外伤性脑损伤患者康复期接受护理措施对激越行为发生发展的影响,评估其影响程度和其他相关影响因素。方法选取2015年8月至2016年12月治疗并于住院康复期间接受护理干预的外伤性脑损伤患者72例为护理组,另选取2014年3月到2015年6月确诊为外伤性脑外伤损伤经过临床治愈的患者65例为对照组,记录所有患者康复前的临床资料并分析2组差异。对所有研究对象进行为期11个月的电话随访,追踪患者激越行为发生人数及频率,根据随访期间是否出现激越行为将2组患者各自分为A组、B组2亚组。随访结束运用生存曲线分析2组患者激越行为发生率的高低,而激越行为发生频率则采用CMAI量表评分表示,秩和检验进行分析; Cox回归分析2组可能影响该组患者激越行为发生的因素并对比影响变量及影响程度差异。结果康复期前2组临床资料无统计学差异(P> 0. 05),具有可比性。至随访结束时,对照组患者激越行为发生率远高于护理组(χ2=6. 315,P=0. 011)且激越行为的发生较为频繁,明显高于护理组(Z=2. 399,P=0. 016); Cox比例风险模型结果显示患者受伤至就诊时间(P=0. 028,RR=1. 706)、轻度脑损伤GCS评分(P=0. 039,RR=1. 472)、中度GCS评分(P=0. 030,RR=1. 973)对激越行为的发生有显著影响;而在对照组中,受教育程度(P=0. 045)、患者受伤至就诊时间(P=0. 036,RR=1. 679)、轻度脑损伤GCS评分(P=0. 037,RR=1. 303)、中度脑损伤GCS评分(P=0. 035,RR=1. 783)、住院时间(P=0. 044,RR=0. 921) 5个因素能显著影响激越行为的发生;中度脑损伤GCS评分、患者受伤至就诊时间均是2组患者中影响程度较高的因素,而轻度脑损伤GCS评分影响程度较低;护理组患者3因素的危险系数均低于对照组(中度GCS:RR=1. 973 VS RR=1. 783;轻度GCS RR=1. 472 vs RR=1. 303; RR=1. 706 vs RR=1. 679)。结论康复期护理对外伤性脑损伤患者治疗后并发激越行为有保护作用,且�Objective To analyze the effects of rehabilitation nursing on agitation behavior in patients with traumatic brain injury and evaluate the influence degree and other related factors.Methods Seventy two patients with traumatic brain injury,who were treated from August 2015 to December 2016 and received nursing intervention during the rehabilitation period,were enrolled as nursing group.Sixty four with traumatic brain injury,who had been treated,were enrolled as control group.The clinical data of all patients before rehabilitation in both groups were recorded and compared.Moreover,a 11-month telephone follow-up was performed on all subjects to learn the incidence and frequency of the agitated behavior.Then,the patients in both groups were subdivided into group A and group B based on whether agitated behavior occurred.The survival curve analysis were made to compared the incidence of agitated behavior between the two groups.And CMAI scale and Rank sum test were used to evaluate the frequency of the agitated behavior.In addition,Cox regression was used to analyze the related factors and compare the difference in related variables and degree between the two groups.Results There were no significant differences in clinical data of patients before rehabilitation between two groups(P>0.05).At the end of the follow-up,the incidence(χ^2=6.315,P<0.05)and frequency(Z=2.399,P<0.05)of agitated behavior in nursing group were significantly higher than those in control group.Cox proportional hazard model showed that the interval between the injury time and visiting time(RR=1.706,P<0.05),GCS score of mild brain injury(RR=1.472,P<0.05)and GCS scores of moderate(RR=1.973,P<0.05)had significant effects on the incidence of the agitated behaviors in nursing group,moreover,education levels(P<0.05),the interval between the injury time and visiting time(RR=1.679,P<0.05).GCS score of mild brain injury(RR=1.303,P<0.05),GCS score of moderate brain injury(RR=1.783,P<0.05)and hospitalization time(RR=0.921,P<0.05)had significant effects on the i

关 键 词：外伤性脑损伤 激越行为 康复期护理 

分 类 号：R473.6[医药卫生—护理学]