癫痫患者长程视频脑电图监测护理规范的建立及效果评价  

Establishing nursing standard for long-range video EEG monitoring in patients with epilepsy and its effect evaluation

作　　者：陈美美 吴玉蓉 柴敏茵 杨慧颖 黄莺 CHEN Meimei;WU Yurong;CHAI Minyin(Department of Neurosurgery,Fudan University Huashan Hospital,Shanghai(200040),Shanghai,China)

机构地区：[1]复旦大学附属华山医院神经外科,上海200040

出　　处：《癫痫与神经电生理学杂志》2024年第5期272-277,共6页Journal of Epileptology and Electroneurophysiology

基　　金：复旦大学附属华山医院院内启动基金(2020QD023)。

摘　　要：目的基于临床诊疗指南及神经外科亚专科护理,应用德尔菲专家咨询法拟定癫痫患者长程视频脑电图(V-EEG)监测护理规范,并应用于临床以评价其效果。方法基于文献检索,结合临床诊疗指南及神经外科亚专科护理,初步拟定癫痫患者长程V-EEG监测护理规范;再应用德尔菲专家咨询法对这些规范进行完善。选取复旦大学附属华山医院神经外科2020年4~10月行长程V-EEG监测的癫痫住院患者38例作为对照组,按神经外科护理常规进行护理;选取2020年11月至2021年4月行长程V-EEG监测的癫痫住院患者41例作为试验组,在神经外科护理常规的基础上,对癫痫患者应用长程V-EEG监测护理规范进行护理。分析比较两组患者在监测期间的癫痫发作频率和不良事件(跌倒坠床、窒息、肺炎及皮肤破损等)发生率。结果对照组与试验组一般资料比较差异无统计学意义(P>0.05),试验组的中位发作频率(3.00次)明显低于对照组(5.00次),差异有统计学意义(Z=-2.085,P=0.037)。不良事件发生率比较:对照组头皮过敏发生率为36.84%、跌倒发生率为2.63%,试验组发生率均为0,提示癫痫患者长程V-EEG监测护理规范可有效降低该两项不良事件发生率。结论经过3轮专家咨询形成的癫痫患者长程V-EEG监测护理规范严谨可靠,临床中严格遵守该护理规范进行护理,不仅能在有限的癫痫发作频次中为致痫灶的定位提供有效依据,还能减少患者头皮过敏等不良事件的发生,提供更加安全有效的监测过程。Objective To establish the nursing standard for long-range video EEG(V-EGG)monitoring for patients with epilepsy using Delphi technique based on clinical diagnosis and treatment guidelines and neurosurgical sub-specialist nursing and evaluate its effect by applying it to clinical practice.Methods Based on literature search combined with clinical diagnosis and treatment guidelines and neurosurgical sub specialty nursing,a preliminary nursing standard for long-range V-EEG monitoring of epilepsy patients was formulated and improved by Delphi technique.A total of 38 inpatients with epilepsy monitored by long-range V-EEG were selected in the Department of Neurosurgery at Huashan Hospital Affiliated to Fudan University from April to October 2020 as control group.Control group was nursed according to the routine of neurosurgery nursing.A total of 41 inpatients epilepsy who underwent long-range V-EEG monitoring from November 2020 to April 2021 were selected as experimental group.On the basis of routine neurosurgery nursing,experimental group was given with long-range V-EEG monitoring.The frequency of epileptic seizures and the incidence of adverse events were analyzed and compared,including such as falls,suffocation,pneumonia,and skin damage between two groups of patients during the monitoring period.Results There was no statistically significant difference in general data between control and experimental groups(P>0.05).The median frequency of seizures in experimental group(3.00 times)was significantly lower than that in control group(5.00 times)(Z=-2.085,P=0.037).Incidence of scalp allergies and falls in control group were 36.84%and 2.63%,respectively,while the incidences in experimental group was 0,suggesting that nursing standards for long-range V-EEG monitoring the patients with epilepsy can effectively reduce the incidences of these two adverse events.Conclusion The nursing standard for long-range V-EEG monitoring patients with epilepsy established via three rounds of expert consultation is rigorous and reliable.In

关 键 词：癫痫 长程视频脑电图监测 护理规范 不良事件 德尔菲专家咨询法 

分 类 号：R742.1[医药卫生—神经病学与精神病学] R741.044[医药卫生—临床医学]