重型颅脑损伤患者的临床护理研究

CLINICAL NURSING OF PATIENTS WITH SEVERE HEAD INJURY RESEARCH

目的探索亚低温治疗仪配合综合护理措施在重型颅脑损伤患者临床护理中的应用及疗效。方法将莒南县板泉中心卫生院诊治的重型颅脑损伤患者69例按随机数字表法分为观察组和对照组,观察组35例,对照组34例。对照组采用颅脑外伤常规治疗方法,包括应用脱水剂、利尿剂、止血剂、抗生素、激素及脑神经营养剂、钙拮抗剂等;观察组在常规治疗的基础上于发病后24h内使用亚低温治疗并配合综合护理措施。治疗3个月后按Glasgow昏迷评分法(GCS)据患者睁眼、语言及运动反应评定临床疗效。结果观察组有88.6%能恢复一定的自理能力,8.6%的需要他人护理,死亡1人,占2.9%。对照组有64.7%能恢复一定的自理能力,29.4%的需要他人护理,死亡2人,占5.9%,两组总疗效比较差异具有统计学意义(P<0.05)。结论使用亚低温治疗仪配合综合护理措施具有较好的临床护理疗效,能有效降低重型颅脑损伤患者的致残率和病死率,提高患者自理能力,值得临床推广应用。

Objective To explore the therapeutic apparatus at low temperature with comprehensive nurs‐ing intervention in patients with severe craniocerebral injury ,the application of clinical nursing and cura‐tive effect .Methods Junan county board springs center hospital diagnosis and treatment of 69 cases of se‐vere craniocerebral injury patients according to random number table method is divided into observation group and control group ,the observation group of 35 cases ,34 cases in the placebo group .Control group adopted routine craniocerebral trauma treatment methods ,including application of dehydrating agent ,diu‐retics ,hemostatic agent ,antibiotic ,hormone and cranial nerve nutrition agent ,calcium antagonists ,etc;Observation group on the basis of conventional treatment within 24 h after the onset of using the low tem‐perature treatment and cooperate with the comprehensive nursing measures .3 months after treatment by the method of Glasgow coma scale （GCS） according to the patients with open ,language and movement re‐sponse evaluation of clinical curative effect .Results Observation group with 88 .6% regained certain self‐care ability ,8 .6% of the need to care others ,1 death ,accounting for 2 .9% .The control group 64 .7% re‐gained certain self‐care ability ,29 .4% of the need to care others ,killed 2 people ,accounting for 5 .9% , the total curative effect compare similar between the two groups have statistical significance （ P〈 0 .05） . Conclusion Comprehensive nursing measures using the low temperature ,an instrument with good clinical nursing curative effect ,can effectively reduce the morbidity and mortality in patients with severe head inju‐ry ,improve the patients＇ self‐care ability , w orthy of clinical popularization and application .