基于量化评估策略的分层干预对重症颅脑外伤术后患者血流变学指标及应激障碍程度的影响  

Effects of Stratified Intervention Based on Quantitative Evaluation Strategy on Hemorheology Indexes and Stress Disorder Degree of Patients After Severe Craniocerebral Trauma Surgery

作　　者：徐欢欢[1] 金小瑞 柳彦涛[1] XU Huanhuan;JIN Xiaorui;LIU Yantao(Department of Critical Care Medicine,Luohe Central Hospital,Luohe 462005,China)

机构地区：[1]漯河市中心医院重症医学科,河南漯河462000

出　　处：《河南医学研究》2025年第1期171-176,共6页Henan Medical Research

摘　　要：目的分析基于量化评估策略的分层干预对重症颅脑外伤术后患者血流变学指标及应激障碍程度的影响。方法选择2021年1月至2022年6月漯河市中心医院重症医学科收治的82例重症颅脑外伤术后患者进行研究,通过随机数字表法分为试验组、对照组,各41例。试验组接受基于量化评估策略的分层干预,对照组接受常规干预,两组均干预至出院,并随访6个月。比较两组康复情况,干预前、干预后营养指标、血流变学指标、运动功能、日常生活能力、昏迷程度,干预前、随访6个月后应激障碍,干预期间并发症及干预后护理满意度。结果试验组住院时间、重症医学科住院时间、肛门排便排气时间、肠鸣音恢复时间短于对照组(P<0.05)。较干预前,干预后两组血清总蛋白(TP)、转铁蛋白(TF)水平,肢体Fugl-Meyer运动功能测评量表(FMA)、Barthel指数评定(BI)、格拉斯哥昏迷评分法(GCS)评分升高,且试验组更高(P<0.05)。较干预前,干预后两组全血黏度、血浆黏度降低,且试验组更低(P<0.05)。较干预前,随访6个月后,两组主观评定、社会功能受损、警觉性增高、反复重现体验、回避症状评分降低,且试验组更低(P<0.05)。较对照组,试验组干预期间并发症发生率更低,干预后护理总满意率更高(P<0.05)。结论基于量化评估策略的分层干预可促进重症颅脑外伤术后患者康复,调节血流变学指标及营养指标,改善运动功能、日常生活能力、昏迷程度,降低远期应激障碍程度,控制并发症发生率,获得患者认可。Objective To analyze the effects of stratified intervention based on quantitative evaluation strategy on hemorheology indexes and stress disorder degree of patients after severe craniocerebral trauma surgery.Methods A total of 82 patients after severe craniocerebral trauma surgery admitted to the Department of Critical Care Medicine of Luohe Central Hospital from January 2021 to June 2022 were selected and divided into experimental group and control group by random number table method,with 41 cases in each group.The experimental group received stratified intervention based on quantitative evaluation strategy,and the control group received routine intervention.Both groups were interventioned until discharge and followed up for 6 months.The two groups of rehabilitation conditions,nutrition index,hemorheology index,motor function,daily living ability,coma degree before intervention and after intervention,stress disorder before intervention and after 6 months of follow-up,complications during intervention and nursing satisfaction after intervention were compared.Results The duration of hospital stay,intensive care hospital stay,anal defecation exhaust time and bowel sound recovery time in experimental group were shorter than those in control group(P<0.05).Compared with before intervention,the levels of serum total protein(TP),transferrin(TF),scores of Fugl-Meyer assessment of motor function(FMA),Barthel index(BI)and Glasgow coma score(GCS)in the two groups increased after intervention,and those of the experimental group were higher(P<0.05).Compared with before intervention,the whole blood viscosity and plasma viscosity of the two groups decreased after intervention,and the experimental group was lower(P<0.05).Compared with before intervention,after 6 months of follow-up,scores of subjective assessment,impaired social function,increased alertness,recurrent experience,and avoidance symptom decreased in both groups,and those in experimental group were lower(P<0.05).Compared with the control group,the complication rate o

关 键 词：颅脑外伤 重症 量化评估 分层干预 血流变学指标 应激障碍 营养指标 

分 类 号：R473.6[医药卫生—护理学]