改进急救护理干预措施对重型颅脑损伤伴脑疝患者并发症和临床预后的影响  

Effects of improved emergency nursing intervention on complications and clinical prognosis in patients with severe craniocerebral injury accompanied by cerebral hernia

作　　者：黄笑英 郭洁欣[1] 朱小冬[1] 何炳华[2] Huang Xiaoying;Guo Jiexin;Zhu Xiaodong;He Binghua(Department of Operation, Dongguan People's Hospital, Dongguan 523059, Guangdong, China;Department of Anesthesiology, Dongguan People's Hospital, Dongguan, 523059, Guangdong, China)

机构地区：[1]东莞市人民医院手术室,广东东莞523059 [2]东莞市人民医院麻醉科,广东东莞523059

出　　处：《中国中西医结合急救杂志》2019年第2期223-226,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：广东省东莞市社会科技发展(一般)项目(201750715001283).

摘　　要：目的观察改进的急救护理干预措施对重型颅脑损伤伴脑疝患者并发症和临床预后的影响,为临床改进护理方式提供依据。方法选择2016年1月至2018年12月在东莞市人民医院就诊的重型颅脑损伤伴脑疝患者。根据入院时间将患者分为常规护理组(2016年1月至2017年6月入院)和改进急救护理干预措施组(2017年7月至2018年12月入院)。分析两种不同护理方式对患者预后的影响。两组患者均行开颅手术,常规护理组采用常规手术室护理,改进急救护理干预措施组在常规护理组基础上釆用改进的急救护理干预方式护理;记录两组患者手术准备时间、手术时间、术中出血量、术后并发症发生率及临床预后;采用自制问卷调查患者的护理满意度及治疗依从性。结果改进急救护理干预措施组40例患者手术准备时间、手术时间及术中出血量均显著低于常规护理组40例患者〔手术准备时间(min): 25.03±5.47比36.73±5.83,手术时间(min): 52.56± 10.63 比 92.10± 10.73,术中出血量(mL): 218.73 ±20.74 比 402.66±23.70,均 P<0.05〕;改进急救护理干预措施组临床预后良好率〔20.0%(8/40)比12.5(5/40)〕、患者护理满意度〔95.0%(38/40)比82.5%(33/40)〕及治疗依从性评分(分:95.83±4.09比81.27±5.04)均显著高于常规护理组(均PV0.05);改进急救护理干预措施组并发症发生率显著低于常规护理组〔32.5%(13/40)比55.0%(22/40), P<0.05〕。结论改进急救护理干预措施能显著提高重型颅脑损伤伴脑疝患者的临床疗效,降低并发症发生率,临床应用价值较高。Objective To explore the effects of improved emergency nursing intervention on complications and clinical prognosis of severe patients with craniocerebral injury accompanied by cerebral hernia, and provide evidence for clinical nursing. Methods The patients with severe craniocerebral injury accompanied by cerebral hernia were enrolled in Dongguan People's Hospital from January 2016 to December 2018. According to the admission time, the patients were divided into routine nursing group (Admission from January 2016 to June 2017) and improved emergency nursing methods group (Admission from July 2017 to December 2018). To analyze the effect of two different nursing methods on the prognosis of patients by improving first aid nursing measures and routine nursing. Both groups of patients underwent craniotomy, the conventional nursing group was treated with routine operating room care, the improved emergency nursing methods group was given improved emergency care interventions based on the conventional nursing, the operation preparation time, operation time, intra-operative blood loss and the incidence of postoperative complications, clinical prognosis of the two groups were observed;the self-made questionnaire was used to evaluate the scores of the patient's satisfaction and compliance. Results The operation preparation time, operation time and intraoperative blood loss of the improved emergency nursing methods group (40 cases) were significantly lower than those in the conventional nursing group [40 cases, operation preparation time (minutes): 25.03 ±5.47 vs. 36.73 ±5.83, operation time (minutes): 52.56± 10.63 vs. 92.10± 10.73, intra-operative blood loss (mL): 218.73±20.74 vs. 402.66±23.70, all P < 0.05];the clinical good prognosis rate, rate of satisfaction to nursing, treatment compliance score of the improved emergency nursing methods group were significantly higher than those of the conventional nursing group [clinical good prognosis rate: 20.0%(8/40) vs. 12.5%(5/40), rate of satisfaction to nursing: 95.0%(38/

关 键 词：改进急救护理 重型颅脑损伤 脑疝 并发症 预后 

分 类 号：R657.4[医药卫生—外科学]