严重脑外伤患者术后废用综合征危险因素分析及护理对策

Risk factors of disuse syndrome in severe traumatic brain injury patients and its nursing countermeasures

目的探究严重脑外伤患者术后废用综合征的危险因素,采取针对性措施提高严重脑外伤患者的预后生活质量。方法回顾性分析严重脑外伤术后并发废用综合征患者28例为观察组,选取同期收治的一般资料相似的56例严重脑外伤术后未并发废用综合征的患者为对照组,比较2组患者的临床资料,采用单因素分析2组患者手术方式、术后心理、医疗护理情况等的差异,筛选相关因素,再采用Logistic多因素回归分析严重脑外伤患者术后并发废用综合征的危险因素,针对相关因素和危险因素探讨预防严重脑外伤术后并发废用综合征的预防对策。结果经logistic多因素回归分析,运动神经受损、感觉神经受损、制动时间≥10d、中重度焦虑、抑郁、家属陪床、康复运动方案执行依从性差为严重脑外伤患者术后并发废用综合征的危险因素。结论影响严重脑外伤患者术后并发废用综合征的危险因素较多,护理人员应紧密配合临床医疗数据,根据患者个体情况,制定针对性的预防措施,降低患者术后并发废用综合征发生率,提高患者预后质量。

Objective To analyze risk factors of disuse syndrome in severe traumatic brain injury patients, and to explore nursing countermeasures to improve the prognosis of the quality of life of patients with severe traumatic brain injury. Methods A total of 28 severe traumatic brain injury patients with postoperative disuse syndrome were in observation group, and another 56 severe traumat- ic brain injury without disuse syndrome were as control group, clinical data of two groups were collect- ed, univariate analysis was used to analyze the difference of surgical ways, postoperative psychology, and medical psychology, related factors were screened, risk factors for disuse syndrome of severe trau- matic brain injury patients were analyzed by logistic multivariate regression analysis, preventive meas- ures of disuse syndrome of severe brain trauma patients was discussed. Results Multivariate logistic regression analysis showed that motor nerve damage, sensory nerve damage, braking time ≥ 10 d, moderate to severe anxiety, depression, family members accompany bed, and poor compliance of re- habilitation exercise program were risk factors for disuse syndrome of severe traumatic brain injury pa- tients. Conclusion Risk factors for disuse syndrome of patients with severe traumatic brain injury are various, nurses should develop targeted prevention measures to reduce postoperative disuse syn- drome according to clinical data of individual patients and to improve prognosis.