系统听觉刺激在脑外伤植物状态患者促醒及并发症预防中的作用

Effects of Voice-aided Awakening on Ventilator-associated Pneumonia for Patients with Persistent Vegetative State

目的探讨系统听觉刺激对促进脑外伤持续植物状态患者苏醒及预防呼吸机相关性肺炎的作用。方法便利选择2011年9月至2012年9月颅脑外伤持续植物状态患者76例,采用随机数字表法将其分为观察组(37例)和对照组(39例)。观察组应用系统听觉刺激,即规律式唤醒、招呼式唤醒及局部声音唤醒;对照组采取常规颅脑损伤护理措施,比较两组患者的听觉诱发电位(brainstem auditory evoked potential,BAEP)变化及呼吸机相关性肺炎的发生率。结果观察组患者肺炎发生率(56.76%)明显低于对照组(71.97%),差异有统计学意义(P<0.05);观察组BAEP波形完全正常(1级)17例、波形呈电静止(4级)1例、语言促醒表现反应性22例,明显较对照组BAEP频率变化及反应性高(P<0.05)。结论系统听觉刺激可促进颅脑外伤持续植物状态患者苏醒,降低呼吸机相关性肺炎的发生率。

Objective To explore the effects of voice-aided awakening on ventilator-associated pneumonia for patients with persistent vegetative state. Methods Totally 76 patients with endotracheal intubation in persistent vegetative state and general anesthesia were randomly divided into two groups. Patients in the observational group（n=37） were given the voice-aided awakening therapy, while patients in the control group（n=39） were given the conventional treatment and nursing. Brainstem auditory evoked potential and incidence of ventilator-associated pneumonia were compared between the two groups. Results The incidence of ventilator-associated pneumonia in experiment group was significantly lower than that in the control group （P〈0.05） ;About 17 cases in experiment group were completely normal of BAEP, only 1 case was BAEP still, and the rate of appearing calling reaction in the experiment group（n=22） obviously surpassed those in the control group （P〈0. 05）. Conclusion The voice-aided awakening therapy can promote the early consciousness recovery for patients with persistent vegetative state and decrease the incidence of ventilator associated pneumonia.