综合护理干预在重症颅脑损伤肠内营养患者的应用

Outcomes of nursing intervention in patients with severe cerebral injury conducting entral nutrition therapy

目的探讨综合护理干预在接受肠内营养(EN)治疗重症颅脑损伤的应用效果。方法行EN治疗的重症颅脑患者187例,随机分为两组:试验组93例,实施综合性的护理干预措施;对照组94例,实施传统的临床护理。记录1、7、14、21d的GCS评分,比较两组患者并发症发生情况和预后。结果试验组腹泻、腹胀和便秘、肢体肌萎缩、抑郁和焦虑发生率均低于对照组(P<0.05或P<0.01)。试验组患者的预后较对照组好,病程14d的GCS评分高于对照组(P<0.01),伤残(7.53%vs.17.02%)和病死率(5.38%vs.8.51%)亦低于对照组(P<0.05)。结论采用综合护理干预措施,能有效增强患者抵御疾病的信心,降低并发症的发生,改善预后。

Objective To observe the outcomes of nursing intervention in the patients with severe cerebral injury conducting entral nutrition（EN） therapy. Methods A total of 187 cerebral injured patients received EN, who were assigned into two groups of A（treated with comprehensive nursing intervention,93 cases） and B（treated with conventional nursing, 94 cases）. The scores Of Glasgow coma scale（GCS） were recorded on the 1st, 7th, 14th and 21st day of EN therapy. The complications and prognosis of two groups were compared. Results The incidences of diarrhea, bloating and constipation, limb muscle atrophy, depression and anxiety were all lower in group A than those in group B（P〈0. 05 or P〈0. 01）. The prognosis of patients in group A was better than that in group B as showed by GCS score on the 14th day[（11.7 ±1. 2） points vs. （10. 5 ± 1.4） points] （P〈0.01）. The incidences of disability（7.53% vs. 17.02%） and mortality（5.38% vs. 8. 51%） were lower in group A than those in group B（P〈0. 05）. Conclusion Application of comprehensive nursing intervention measures can effectively enhance the confidence of patients against disease, reduce the incidence of complications, and improve the prognosis of the patients with severe cerebral injury undergoing EN therapy.