多元刺激性干预对重症颅脑损伤患者促醒作用及神经功能和并发症的影响  

Effect of multiple stimulation intervention on wake-up,neurological function and complications in patients with severe craniocerebral injury

作　　者：王晨清 王昱 杜祥飞 毛亚松 张海伟 WANG Chen-qing;WANG Yu;DU Xiang-fei;MAO Ya-song;ZHANG Hai-wei(Department of Anesthesiology and Perioperative Medicine,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,Jiangsu,China;Department of Neurosurgery ICU,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,Jiangsu,China)

机构地区：[1]南京医科大学第一附属医院麻醉与围手术期医学科,江苏南京210029 [2]南京医科大学第一附属医院神经外科ICU,江苏南京210029

出　　处：《川北医学院学报》2024年第11期1580-1584,共5页Journal of North Sichuan Medical College

基　　金：江苏省社科联研究课题(22SYB-017);临床能力提升工程护理项目(JSPH-NC-2022-21)。

摘　　要：目的:探讨多元刺激性干预对重症颅脑损伤(STBI)患者的促醒作用及神经功能和并发症的影响。方法:选取180例STBI患者为研究对象,按照护理干预方式不同分为对照组和观察组,每组各90例。对照组患者行常规护理干预;观察组患者在常规护理基础上联合多元刺激性干预,干预时间均为30 d。比较两组患者干预15、30 d苏醒情况(苏醒率和苏醒时间);干预前及干预30 d神经功能[格拉斯哥昏迷量表(GCS)评分、美国国立卫生研究院卒中量表(NIHSS)评分]、认知功能[认知障碍分级评定表(RLA)评分];重症监护室(ICU)住院时间及并发症发生情况。结果:干预30 d,观察组患者苏醒率高于对照组(62.22%vs.41.11%,P<0.05);平均苏醒时间短于对照组[(18.34±4.42)d vs.(26.12±6.31)d,P<0.05];GCS评分及RLA评分高于对照组(P<0.05);NHISS评分低于对照组(P<0.05)。观察组患者ICU住院时间短于对照组[(11.86±1.01)d vs.(13.79±1.37)d,P<0.05];并发症总发生率低于对照组(8.89%vs 21.11%,P<0.05)。结论:对STBI患者实施多元刺激性干预可促进患者苏醒,改善患者神经功能及认知功能,减少并发症发生。Objective:To investigate the effect of multiple stimulation intervention on wake-up,neurological function and complications in patients with severe traumatic brain injury(STBI).Methods:180 patients with STBI were divided into control group(n=90)and observation group(n=90)according to different nursing methods.The control group was given routine nursing,the observation group was combined with multiple stimulation intervention on the basis of routine nursing,and the intervention time was 30 days in both group.The recovery rate and recovery time of the two groups were compared at 15 and 30 d after intervention.The neurological function[Glasgow Coma Scale(GCS),National Institutes of Health Stroke Scale(NIHSS)],cognitive function[Cognitive Impairment Rating Scale(RLA)scores],intensive care unit(ICU)stay time and complications were compared between the two groups before intervention and 30 d after intervention.Results:Compared with the control group,the recovery rate of the observation group was higher(41.11%vs.62.22%,P<0.05).Compared with the control group,the average recovery time of the observation group was shorter[(26.12±6.31)d vs.(18.34±4.42)d,P<0.05].After 30 days of intervention,compared with the control group,the GCS score and RLA score of the observation group were higher(P<0.05),and the NHISS score was lower(P<0.05).Compared with the control group,the ICU hospitalization time of the observation group was shorter[(13.79±1.37)d vs.(11.86±1.01)d,P<0.05].Compared with the control group,the incidence of total complications in the observation group was lower(21.11%vs.8.89%,P<0.05).Conclusion:Multiple stimulation intervention for STBI patients can promote the recovery of patients,improve the neurological function and cognitive function of patients,and reduce the incidence of complications.

关 键 词：刺激性干预 重症颅脑损伤 昏迷 神经功能 并发症 

分 类 号：R47[医药卫生—护理学]