针对性护理在颅脑损伤去骨瓣减压术后行颅骨缺损修补术患者中的应用  

Application of targeted nursing in postoperative patients undergoing cranial defect repair after decompressive craniectomy for traumatic brain injury

作　　者：金薇薇[1] 肖莹[1] 侯俊玲[2] 孙阳[2] Jin Weiwei;Xiao Ying;Hou Junling;Sun Yang(Operating Room, the First Bethune Hospital of Jilin University-DivisionⅡ, Changchun 130031, China;Department of Neurosurgery, the First Bethune Hospital of Jilin University-DivisionⅡ, Changchun 130031, China)

机构地区：[1]吉林大学第一医院二部手术室,长春130031 [2]吉林大学第一医院二部神经外科,长春130031

出　　处：《中华现代护理杂志》2019年第28期3641-3645,共5页Chinese Journal of Modern Nursing

基　　金：吉林大学第一医院科研专项基金(SZ2014099647325J).

摘　　要：目的探讨针对性护理在颅脑损伤去骨瓣减压术后行颅骨缺损修补术患者中的应用效果,及对术后并发症影响。方法选取吉林大学第一医院二部神经外科在2017年1月—2018年12月针对颅脑损伤去骨瓣减压术后行颅骨缺损修补手术的患者400例,随机分为观察组(200例)和对照组(200例)。对照组接受常规护理,观察组则接受针对性护理。比较两组患者的格拉斯哥昏迷量表(GCS)评分、国立卫生研究院卒中量表(NIHSS)评分、面部疼痛表情量表(FRS)评分、去骨瓣减压术与颅骨缺损修补术的间隔时间、颅骨缺损修补术后拔管时间、拆线时间、住院时间、并发症发生率、格拉斯哥预后评分(GOS)评分、卡氏功能状态评分标准(KPS)评分。结果两组患者NIHSS评分与FRS评分均下降,GCS评分升高,且观察组均优于对照组,差异有统计学意义(P<0.05)。两组患者两种手术的间隔时间、颅骨缺损修补术后拔管、拆线及住院时间比较,观察组均短于对照组(P<0.05)。观察组并发症发生率为6.00%,低于对照组的13.50%(P<0.05)。观察组术后GOS评分为4~5分的比例为79.50%,大于对照组的69.00%,观察组低分率小于对照组(P<0.05)。观察组KPS评分高于对照组(P<0.05)。结论对接受颅脑损伤去骨瓣减压术后行颅骨缺损修补术患者进行针对性护理能够提高其GCS、GOS、KPS的评分,降低其NIHSS评分和并发症发生率,缩短去骨瓣减压术与颅骨缺损修补术的间隔时间、颅骨缺损修补术后拔管时间、拆线时间及住院时间,更能较好地衔接两个手术。Objective To explore the application effect of targeted nursing in postoperative patients undergoing cranial defect repair after decompressive craniectomy for traumatic brain injury and the impact on the postoperative complications. Methods From January 2017 to December 2018, 400 patients who underwent cranial defect repair after decompressive craniectomy for traumatic brain injury in Department of Neurosurgery, the First Bethune Hospital-Division Ⅱ were selected and randomly divided into observation group (n=200) and control group (n=200). The control group received routine nursing, while the observation group received targeted nursing. Scores of the Glasgow Coma Scale (GCS), National Institutes of Health Stroke Scale (NIHSS) and Face Rating Scale (FRS), the interval between decompressive craniectomy and cranial defect repair , extubation time, suture removal time, hospitalization time and incidence of complications, scores of Glasgow Outcome Score (GOS) and Karnofsky Performance Status (KPS) were compared between the two groups. Results The NIHSS score and FRS score of both groups decreased, while the GCS score increased, and the observation group was better than the control group, the differences were statistically significant (P<0.05). The interval time between the two kinds of operations, extubation, suture removal and hospitalization time after cranial defect repair were shorter in the observation group than in the control group (P<0.05). The incidence of complications in the observation group was 6.00%, which was lower than 13.50% in the control group (P<0.05). The ratio of GOS score between 4 to 5 of the observation group was 79.50%, which was higher than 69.00% of the control group, and the rate of low scores of the observation group was lower than that of the control group (P<0.05). The KPS score of the observation group was higher than that of the control group (P<0.05). Conclusions Application of targeted nursing in postoperative patients undergoing cranial defect repair after decompressive craniect

关 键 词：颅脑损伤 去骨瓣减压术 颅骨缺损修补术 并发症 针对性护理 

分 类 号：R473.6[医药卫生—护理学]