高压氧综合护理模式对早期重型颅脑损伤的影响及护理对策

The effect and nursing strategy of hyperbaric oxygen comprehensive nursing in patients with early severe craniocerebral injury

目的探讨高压氧综合护理对重型颅脑损伤患者的疗效。方法对于高压氧综合护理的早期重型颅脑损伤患者进行回顾性研究,对照组给予高压氧常规护理,研究组给予高压氧综合护理,包括制定护理重点,康复计划及预见性护理措施。对比不同护理的两组患者在治疗过程中并发症发生率及因并发症中断高压氧治疗时间的差异,并比较两组高压氧不良反应发生率的差别。采用GCS评分行近期疗效评定。采用远期生活质量评估量表(KPS)行远期生活质量评定。结果高压氧治疗及高压氧综合护理3个疗程后,研究组消化道出血发生(4/42)较对照组(14/41)减少,因并发症中断高压氧治疗的时间[(13.64±2.78)d]比对照组[(20.90±8.96)d]缩短,高压氧不良反应的发生(0/42)比对照组(4/41)显著下降,治疗前后GCS评分及治疗后KPS评分均明显优于对照组,差异均有统计学意义(均P<0.05)。结论高压氧综合护理对早期重型颅脑损伤患者具有更佳的临床效果和更大的安全性。

Objective To evaluate the clinical effect of hyperbaric oxygen comprehensive nursing on severe craniocerebral injury with hyperbaric oxygen treatment.Methods Clinical data of patients with severe craniocerebral injury and hyperbaric oxygen treatment were analyzed retrospectively.The patients receiving usual care were assigned to the control group and those receiving hyperbaric oxygen comprehensive care were assigned to the intervention group,which applied nursing strategies,rehabilitation program and predictable nursing measures.Complication incidence and discontinuation of hyperbaric oxygen treatment from complications were compared between the intervention group and control group.The incidence of hyperbaric oxygen side effects was analyzed.Glasgow coma score （GCS） was used to evaluate short-term effect and Karnolaky performance scale （KPS） was used to assess long-term effect.Results After three courses of hyperbaric oxygen treatment and comprehensive nursing,the occurrence of digestive tract hemorrhage following severe craniocerebral injury was lower （4/42） than control group （14/41） and the discontinuation of treatment was shorter in intervention group [（13.64±2.78） d] than control group [（20.90±8.96） d].Intervention group also reported significantly less side effect of hyperbaric oxygen （0/42） than control group （4/41）.GCS and KPS were significantly improved in intervention group,with the statistically significant differences （all P ＜ 0.05）.Conclusion Hyperbaric oxygen comprehensive nursing takes better clinical effect and security in patients with severe craniocerebral injury during the hyperbaric oxygen treatment.