基于eCASH理念的镇静镇痛护理模式在重症脑外伤患者术后应用的价值研究

Value of Sedation and Analgesia Nursing Mode Based on eCASH Concept in Patients with Severe Brain Injury after Surgery

目的探讨基于舒适化浅镇静策略(Early Comfort Using Analgesia,Minimal Sedatives and Maximal Hu⁃mane Care,eCASH)理念的镇静镇痛护理模式在重症脑外伤患者术后应用的价值。方法随机选取2021年1月—2023年1月福建医科大学附属协和医院收治的重症脑外伤患者90例为研究对象,按随机数表法分为对照组和镇静镇痛护理模式组,每组45例。对照组患者接受临床重症脑外伤手术患者常规护理,镇静镇痛护理模式组患者在常规护理基础上加入基于eCASH理念的镇静镇痛护理模式。对比两组患者的镇静镇痛效果、生活质量。结果干预1周后,镇静镇痛护理模式组患者疼痛行为量表的面部表情、上肢活动、呼吸机顺应性评分值均低于对照组患者(P均<0.05)。出院当日,镇静镇痛护理模式组生活质量综合评定量表中躯体功能(16.11±2.54)分、生理状态(17.74±2.04)分、心理功能(15.11±2.12)分、社会功能(16.71±2.88)分均高于对照组(t=4.580、6.548、7.450、5.838,P均<0.05)。结论基于eCASH理念的镇静镇痛护理模式应用于重症脑外伤手术患者中,可有效提高镇痛镇静效果、促进术后康复、提升生活质量。

Objective To explore the value of sedation and analgesia nursing mode based on the concept of early comfort using analgesia,minimal sedatives and maximal humane care(eCASH)in patients with severe brain injury after surgery.Methods A total of 90 patients with severe traumatic brain injury admitted to Union Hospital Affiliated to Fujian Medical University from January 2021 to January 2023 were randomly selected and divided into control group and sedation and analgesia nursing mode group with 45 cases respectively by random number table method.The control group received routine nursing care for patients undergoing severe brain trauma surgery,and the sedative and analgesic nursing mode was added to the routine nursing mode based on the eCASH concept.The effects of sedation,analgesia and quality of life were compared between the two groups.Results After 1 week of intervention,the facial expression,upper limb activity and ventilator compliance scores of the behavior pain scale in sedative and analgesic nursing mode group were lower than those in control group(all P<0.05).On the day of discharge,the scores of physical function(16.11±2.54)points,physiological state(17.74±2.04)points,psychological function(15.11±2.12)points and social function(16.71±2.88)points in the comprehensive assessment scale of quality of life in the sedative and analgesic nursing mode group were higher than those in control group,and the differences were statistically significant(t=4.580,6.548,7.450,5.838,all P<0.05).Conclusion The sedative and analgesic nursing mode based on eCASH concept can effectively improve the analgesic and sedative effect,promote postoperative rehabilitation and improve the quality of life in patients with severe brain trauma.