重症脑血管病并发高渗血症患者的护理监测进展

Nursing monitoring of progress on the patients with severe cerebral vascular disease complicated with hypernatremia

目的探讨重症脑血管病并发高渗血症患者的护理监测疗效。方法选取我院2009年1月～2011年6月收治的重症脑血管病并发高渗血症老年患者30例,对所有患者进行有效的护理监控,主要内容包括患者血糖、血钠、血钾的监测,进而控制机体补液量、利尿药用量、血糖水平,动态观察患者干预前后血浆渗透压的变化情况,分析比较患者护理监测干预前后的临床疗效。结果护理监测干预后患者血浆渗透压[(301.3±10.5)mmol/L]、血钠[(138.2±5.4)mmol/L]、血糖[(7.9±1.8)mmol/L]、血尿素氮[(7.4±2.3)mmol/L]均明显低于护理监测干预前患者的血浆渗透压(329.8±17.6)mmol/L、血钠(147.9±8.0)mmol/L、血糖(8.7±2.5)mmol/L、血尿素氮(9.6±3.1)mmol/L。护理监测干预后患者血钾(4.9±0.7)mmol/L明显高于护理监测干预前患者血钾(4.1±0.6)mmol/L。护理监测干预成功患者住院病死率(22.7%)明显低于护理监测干预不成功患者住院病死率(100.0%)。差异均有统计学意义(均P<0.05)。结论对重症脑血管病并发高渗血症患者采取有效的护理监测措施,可以大幅降低患者的血浆渗透压,进而改善患者重症脑血管病病情,降低住院病死率,是一种安全有效的治疗方法,值得临床推广使用。

Objective To investigate nursing monitoring effect on the patients with severe cerebral vascular disease complicated with hypernatremia.Methods 30 elderly patients with severe cerebral vascular disease complicated with hypernatremia were selected in the hospital from January 2009 to June 2011.All patients were effectively nursing monitoring.The main contents included blood glucose,serum sodium,serum potassium monitoring,control of body fluids,diuretic dosage,blood glucose level,dynamic observation of patients with plasma before and after intervention osmotic pressure changes.Patient care monitoring before and after the intervention of clinical curative effect were analysed and compared.Results The plasma osmotic pressure monitoring（301.3±10.5） mmol/L,serum sodium（138.2±5.4） mmol/L,glucose（7.9±1.8） mmol/L,blood urea nitrogen（7.4±2.3） mmol/L of patients after nursing monitoring intervention were significantly lower than the plasma osmotic pressure monitoring（329.8±17.6） mmol/L,serum sodium（147.9±8.0） mmol/L,glucose（8.7±2.5） mmol/L,blood urea nitrogen（9.6±3.1） mmol/L of patients before nursing monitoring intervention.The blood potassium（4.9±0.7） mmol/L） of patients after nursing monitoring intervention was higher than the blood potassium（4.1±0.6） mmol/L of patients before nursing monitoring intervention.The hospital mortality of patients with successful nursing monitoring intervention（22.7%） was significantly lower than the hospital mortality of patients with non-successful nursing monitoring intervention（100%）.The differences were statistically significant（P 0.05）.Conclusion Taking effective nursing measures on severe cerebral vascular disease complicated with hypernatremia patients can greatly reduce the patient＇s plasma osmotic pressure and improve the patients with severe cerebral vascular disease,which can also reduce mortality rate.