去骨瓣减压术后脑膨出患者早期应用弹力绷带适度加压包扎的护理效果评价

The nursing efficacy evaluation of decompressive craniectomy after brain swelling in patients with early application of elastic bandage bandaged appropriate

目的探讨去骨瓣减压术后脑膨出患者早期应用弹力绷带适度加压包扎的护理效果。方法入组对象为2011年12月-2014年10月入住我院的60例行去骨瓣减压术的重症颅脑损伤患者,均经CT、MRI等影像学手段确诊。将其按1∶1的比例分为对照组与观察组,对照组给予降颅压、控制感染及维持水电解质平衡等治疗,观察组在此基础上采用弹力绷带适度加压包扎治疗与护理。比较两组患者脑膨出情况、ICP、CPP、临床疗效。结果 （1）观察组脑膨出发生率、脑膨出程度及ICP水平均显著小于对照组,差异均具有统计学意义（P〈0.05）,观察组CPP水平显著高于对照组（P〈0.05）;（2）观察组头痛、头晕/眩晕、骨窗膨隆发生率及骨窗塌陷时间均显著优于对照组,差异均具有统计学意义（P〈0.05或P〈0.01）。结论与常规治疗方式相比,行去骨瓣减压术的重症颅脑损伤患者早期应用弹力绷带适度加压包扎,可有效降低脑膨出及不良反应发生率。

Objective To investigate the efficacy of decompressive craniectomy after brain swelling in patients with early application of elastic bandage bandaged appropriate. Methods From December 2011 to October 2014 in our hospital, 60 cases of decompressive craniectomy in severe craniocerebral injury patients were selected as objects, and they were confirmed by CT, MRI and other imaging diagnostic methods. They were divided into control group and the observation group in the 1∶1 ratio, the control group was given the reduce intracranial pressure, infection control and maintain water and electrolyte balance treatment, observation group on the basis of elastic bandage bandaged appropriate treatment and care. The encephalocele cases, ICP, CPP, clinical efficacy were compared between two groups. Results（1）Encephalocele incidence, degree of brain swelling and ICP of observation group were significantly lower than the control group, the difference was significant between two groups（P〈0.05）, CPP of observation group were significantly higher than that of control group（P〈0.05）;（2）Headache, dizziness/vertigo, bone window bulging incidence and bone window collapse time of observed group was significantly better than the control group, the differences were statistically significant between two groups（P〈0.05 or P0.01）. Conclusion Compared with conventional treatment, the line early decompressive craniectomy in patients with elastic bandage bandaged moderately severe head injury, brain swelling and can effectively reduce the incidence of adverse reactions, should performed in clinical practice, use.