低温治疗重型颅脑损伤病人的护理

Experience on Nursing Patient with Serious Head Injury with Cryotherapy

目的:为了降低重型颅脑损伤病人的致残率和病死率．方法:采用低温疗法(34～36℃)治疗90例．低温治疗期间密切观察意识、瞳孔、生命体征、颅内压的变化及上消化道出血征象,发现异常及时处置;加强基础护理和气管切开护理,严格无菌操作,预防褥疮及感染．结果:痊愈33例,轻残18例,中、重残12例,死亡27 例,较1997年11月以前同类病人的病死率下降了17％．结论:低温治疗可使病人保持自主呼吸,生命体征变化幅度减小,病死率降低．

In order to reduce the invalidity rate and death rate caused by serious head injury, 90 patients were treated with cryotherapy （34- 36℃） from November in 1997 to August in 2004. During the period of the treatment, the doctors handled the abnormal phenomena in time while they were observing the state of consciousness, pupil, intracranial pressure and signs and symp- toms for hemorrhage of upper alimentary track. Meanwhile, we strengthened basic nursing and performed tracheotomy with strict asepsis and took precautions against bed sore and infection. As a result, 33 patients perfectly recovered and 18 cases became slightly crippled; 12 patients were severely disabled and 27 cases died at last. However, the death rate of the same disease still dropped 17 % compared with that before November in 1997. Therefore, cryotherapy can make the patients breathe freely and their physical Signs change within a narrow range, which bring about the decrement of the death rate .