闭锁综合征患者的早期康复护理

Early-stage Rehabilitation Nursing for Patients with Locked-in Syndrome

总结11例闭锁综合征患者的早期康复护理经验。从患者入院抢救开始,即由经过培训的急诊护士给予早期全面康复干预措施,为后期康复计划的顺利开展和实施奠定了良好的基础,包括早期心理康复,使患者以积极的心态配合治疗和护理;语言早期康复护理;吞咽的早期康复,避免患者舌肌和吞咽肌群发生萎缩;并根据患者生命体征稳定情况进行合理的肢体功能早期康复,从而促进患者的神经功能缺损程度的减轻,使患者的生存质量得到保障。本组11例患者中1例因发生严重并发症死亡,其余患者均积极配合治疗、护理,出院时5例患者口齿清楚能正常交流,3例患者口齿含糊,但能进行简单对话,2例患者能发出单音或双音节词;7例患者能自行进食;5例患者能自行行走,3例患者需人掺扶,2例患者可坐轮椅。

This paper summarizes the nursing experience for 11 cases with locked-in syndrome. From the very moment of emergency rescue, overall nursing interventions were offered by trained emergency nurses, which laid a solid foundation for the subsequent carrying out of the rehabilitation plan. These interventions included： （1） psychological nursing intended for the patients＇ positive mind to cooperate in the treatment and nursing; （2） lingual nursing; （3） swallowing nursing to prevent the withering of the patients＇ tongue and swallowing muscle group; （4） reasonable limb function rehabilitation training in light of the patients＇ stability of the vital sign intended for the alleviation of the damage or loss of the neurological function and thus the guarantee of the existence quality. Of the 11 cases, 1 died of severe complications, and all the other cooperated actively in the treatment and nursing. At discharge from the hospital, 5 could conduct normal communications in an articulate manner, 3 talked inarticulately, but could have simple talks, and 2 could utter monosyllables and disyllables. 7 could eat independently, 5 could walk by themselves, 3 could walk with other＇s support and 2 could take the wheelchair.