重型颅脑损伤早期护理干预的效果观察

The clinical efficacy of early nursing care in patients with severe craniocerebral injury

目的 对重型颅脑损伤病人早期实施护理干预措施的效果观察.方法 将2011年1月至2012年12月我科共收治重型颅脑损伤98例病人随机分成常规组和康复组,各49例,常规组按原常规治疗及护理,康复组在常规治疗护理的基础上早期实施肠内营养、肢体功能锻炼、高压氧、针灸、心理护理等干预措施.结果 两组病人伤后经治疗2个月后采用GOS评价标准评价,康复组恢复达5分增加21％,4分增加12％,3分下降14％,2分下降6％,1分下降12％,采用Barthel日常生活能力评分标准进行比较,康复组恢复达0级上升8％,1级上升13％,2级下降9％,3级下降14％,经统计学分析发现,康复组效果优于对照组,两组比较差异有统计学意义（P＜0.05）.结论 早期实施护理干预措施能促进重型颅脑损伤病人脑功能和肢体功能的恢复,对提高生存质量具有重要意义.

Objective To investigate the clinical efficacy of early nursing care in patients with severe craniocerebral injury.Methods 98 cases of severe craniocerebral injury in our department were randomly divided into control group and rehabilitation group from Jan.2011 to Dec.2012,49 cases in each group.Control group underwent conventional treatment and care,while rehabilitation group underwent a series of additional healthcare including early enteral nutrition,physical functional exercise,hyperbaric oxygen,acupuncture and psychological care.Results Two groups were both assessed by 2-months GOS evaluation.Rehabilitation group eventually increased by 21％ at GOS 5 level,12％ at GOS 4 level,otherwise decreased by 14％ at GOS 3 level,6％ at GOS 2 level,12％ at GOS 1 level respectively.Barthel ADL score showed,rehabilitation group eventually restore up to 0 level by 8％,1 level by 13％,decrease 2 level by 9％,3 level by 14％.Short-term effect of rehabilitation group improved more obviously than that of control group （P ＞ 0.05）.Conclusion Early nursing care can promote brain function,limb function,the quality of life in patients with severe craniocerebral injury.