气脉冲K点刺激口腔护理对颅脑损伤意识障碍患者的促醒效果  

Effect of air-pulse therapy combined with K-point stimulating oral care on awakening of traumatic brain injury patients with consciousness disturbance

作　　者：詹梦梅 胡娇娇 王建宁[2] 罗晶 曹梦娟 熊安萍 邵秀芹[3] 郑茶凤[3] 徐萍[1] ZHAN Mengmei;HU Jiaojiao;WANG Jianning;LUO Jing;CAO Mengjuan;XIONG Anping;SHAO Xiuqin;ZHENG Chafeng;XU Ping(Department of Neurosurgery,the First Affiliated Hospital of Nanchang University,Nanchang 330006,Jiangxi,China;Department of Nursing,the First Affiliated Hospital of Nanchang University,Nanchang 330006,Jiangxi,China;Department of Rehabilitation,the First Affiliated Hospital of Nanchang University,Nanchang 330006,Jiangxi,China)

机构地区：[1]南昌大学第一附属医院神经外科,江西南昌330006 [2]南昌大学第一附属医院护理部,江西南昌330006 [3]南昌大学第一附属医院康复医学科,江西南昌330006

出　　处：《护士进修杂志》2024年第5期539-543,共5页Journal of Nurses Training

基　　金：江西省中医药科技计划(编号:2021B193);江西省卫生厅科技计划(编号:202110011);江西省教育厅科技计划(编号:GJJ200238)。

摘　　要：目的评价气脉冲K点刺激口腔护理为主要形式的超早期促醒对颅脑损伤(TBI)意识障碍患者的促醒效果。方法便利抽样选取2022年1-9月南昌大学第一附属医院神经外科TBI意识障碍患者100例,最终纳入研究95例,将2022年1-4月的48例患者设为对照组,2022年6-9月的47例患者设为观察组,5月为洗脱期。对照组在常规促醒治疗的基础上采取传统口腔护理方法,观察组在对照组基础上采用气脉冲K点刺激口腔护理,频率为1次/6 h。比较2组患者干预前、干预后2周、4周意识状态和口腔情况,采用修订版昏迷恢复量表(CRS-R)、格拉斯哥评分(GCS)及RLAS-R认知功能分级量表评估患者意识状态及认知功能的改变,采用改良Beck口腔评估法评估患者口腔情况,同时以横断面方式记录2组口腔护理操作时间。结果干预前,2组患者CRS-R、GCS以及RLAS-R评分,Beck评分比较,差异均无统计学意义(P>0.05)。经干预后2周、4周,患者CRS-R、GCS以及RLAS-R评分逐渐提升,观察组得分高于对照组,差异均具有统计学意义(P<0.05);Beck评分逐渐下降,观察组Beck评分低于对照组,口腔情况优于对照组(P<0.05)。治疗期间2组患者均未发生不良安全事件及不良反应。观察组口腔护理时间短于对照组。结论气脉冲K点刺激方法辅助口腔护理,以临床常见操作为捆绑,实现多频次和规律的感觉刺激,能够改善患者的意识水平,提高口腔护理质量。Objective To evaluate the ultra-early stages awakening promoting effect of air-pulse therapy combined with K-point stimulating oral care on traumatic brain injury(TBI)patients with consciousness disturbance.Methods A total of 100 TBI patients with consciousness disorder in the neurosurgery department of the First Affiliated Hospital of Nanchang University from January to September 2022 were selected by convenient sampling method,and 95 cases were finally included in the study.Forty-eight patients from January 2022 to April 2022 were set as the control group,47 patients from June to September 2022 were set as the observation group,and May was the washout period.The patients in the control group were given traditional oral care on the basis of the conventional awakening treatment,while the patients in the observation group was given air-pulse therapy combined with K-point stimulating oral care on the basis of the control group,with the frequency of 1 time/6 hours.The conscious state and oral status of 2 groups were compared before intervention,2 weeks and 4 weeks after intervention.The changes of consciousness state and cognitive function of patients were evaluated by the modified Coma Recovery Scale-Revised Scale(CRS-R),Glasgow Coma Scale(GCS),and Rancho Los Amigos Scale-Revised Cognitive Function Rating Scale(RLAS-R),and the modified Beck Oral Assessment was used to evaluate the oral status of patients.Meanwhile,the operation time of oral care in 2 groups was recorded in a cross-sectional way.Results Before intervention,there were no significant differences in CRS-R,GCS,RLAS-R,and Beck scores between 2 groups(P>0.05).After 2 weeks and 4 weeks of intervention,the scores of CRS-R,GCS,and RLAS-R gradually increased,and the scores of the observation group were higher than those of the control group with statistical significance(P<0.05).The Beck score gradually declined,which of the observation group was lower than that of the control group,and the oral condition in the observation group was better than that in the co

关 键 词：气脉冲 K点刺激 口腔护理 昏迷促醒 颅脑损伤 

分 类 号：R473.6[医药卫生—护理学] R651.15[医药卫生—临床医学]