基于多模式神经电生理监测的多层次护理模式在急性一氧化碳中毒后迟发性脑病预防中的应用  

Application of multi-level nursing mode based on multi-modal nerve electrophysiology monitoring in the prevention of delayed encephalopathy after acute carbon monoxide poisoning

作　　者：郭婷婷 邹倩 方梅 GUO Ting-ting;ZOU Qian;FANG Mei(WardⅡ,Department of Neurology,Ankang Central Hospital,Ankang 725000,Shaanxi,CHINA)

机构地区：[1]安康市中心医院神经内科二病区,陕西安康725000

出　　处：《海南医学》2023年第3期409-413,共5页Hainan Medical Journal

基　　金：陕西省科技厅计划项目(编号:QS061-C33-21)。

摘　　要：目的探讨基于多模式神经电生理监测的多层次护理模式在急性一氧化碳(CO)中毒后迟发性脑病(DEACMP)预防中的应用效果。方法选取2019年1月至2022年1月安康市中心医院收治的122例急性CO中毒患者作为研究对象。将2019年1月至2020年5月收治的61例患者纳入对照组,将2020年6月至2022年1月收治的61例患者纳入观察组。两组患者均采用高压氧治疗,对照组予以常规护理干预,观察组予以基于多模式神经电生理监测的多层次护理模式,均持续护理两周。比较两组患者的DEACMP发生率和治疗期间的并发症情况;比较两组患者护理前和护理两周后的神经功能、心理健康水平和疾病认知水平,以及出院时对护理的满意度和出院后6个月后的生活质量。结果观察组患者的DEACMP发生率为3.28%,明显低于对照组的14.75%,差异有统计学意义(P<0.05);两组患者治疗期间的脑水肿、肺炎、皮肤损伤、泌尿感染和心肌损伤并发症发病率比较差异均无统计学意义(P>0.05);护理两周后,观察组与对照组患者的蒙特利尔认知评估量表(MoCA)评分[(28.12±1.06)分vs(27.03±1.84)分]、简易精神状态检查量表(MMSE)评分[(27.35±1.54)分vs(25.12±1.26)分]、CO中毒[(12.14±1.57)分vs(10.65±1.85)分]、中毒后常见急救[(18.13±0.96)分vs(16.67±0.77)分]和DEACMP[(25.64±2.47)分vs(23.12±2.69)分]相关知识认知水平评分比较,观察组明显高于对照组,差异均有统计学意义(P<0.05);观察组与对照组患者的焦虑自评量表(SAS)评分[(35.48±4.89)分vs(39.32±5.11)分]与抑郁自评量表(SDS)评分[(31.14±4.55)分vs(37.75±6.64)分]比较,观察组明显低于对照组,差异均有统计学意义(P<0.05);观察组与对照组患者的环境护理[(90.23±5.14)分vs(85.47±6.61)分]、心理护理[(92.56±4.47)分vs(88.32±4.28)分]、健康教育[(91.55±4.71)分vs(88.37±6.69)分]和病情观察[(93.57±2.66)分vs(87.62±6.69)分]等护理满意度评分比较,观察Objective To explore the application effect of multi-level nursing mode based on multi-modal nerve electrophysiology monitoring in the prevention of delayed encephalopathy after acute carbon monoxide(CO)poisoning(DEACMP).Methods A total of 122 patients with acute CO poisoning admitted to the hospital were enrolled as the research objects between January 2019 and January 2022,including 61 cases admitted between January 2019 and May 2020 in the control group and 61 cases admitted between June 2020 and January 2022 in observation group.Based on hyperbaric oxygen therapy,the control group was given routine nursing,while the observation group was given multi-level nursing mode based on multi-modal nerve electrophysiology monitoring,continuously for 2 weeks.The incidence of DEACMP,complications during treatment,nerve function,psychological health,and disease cognition before and after 2 weeks of nursing,nursing satisfaction at discharge,and quality of life at 6 months after discharge were compared between the two groups.Results The incidence of DEACMP in the observation group was significantly lower than that in the control group(3.28%vs 14.75%,P<0.05).There was no significant difference in the incidence of brain edema,pneumonia,skin injury,urinary infection,and myocardial injury between the two groups during treatment(P>0.05).After 2 weeks of nursing,scores of Montreal Cognitive Assessment(MoCA)[(28.12±1.06)points vs(27.03±1.84)points],Mini-Mental State Examination(MMSE)[(27.35±1.54)points vs(25.12±1.26)points],cognition to CO poisoning[(12.14±1.57)points vs(10.65±1.85)points],common first aids after poisoning[(18.13±0.96)points vs(16.67±0.77)points],and DEACMP related knowledge[(25.64±2.47)points vs(23.12±2.69)points]were significantly higher in the observation group than the control group(P<0.05).The scores of Self-rating Anxiety Scale(SAS)[(35.48±4.89)points vs(39.32±5.11)points]and Self-rating Depression Scale(SDS)[(31.14±4.55)points vs(37.75±6.64)points]were significant-ly lower in the observation g

关 键 词：急性一氧化碳中毒 迟发性脑病 神经电生理监测 多层次护理 神经功能 

分 类 号：R473.74[医药卫生—护理学]