颅内压监护在小儿颅脑损伤中的应用及护理

Application and nursing of intracranial pressure monitoring in children with craniocerebral injury

目的 探讨颅内压监护在颅脑损伤患儿中的应用效果及护理方法。方法 收集2011年3月~2015年12月在我院治疗的颅脑损伤患儿40例,随机分两组,对照组20例主要采取常规的神经外科护理,通过观察意识、瞳孔及肢体活动情况的变化,监测生命体征,遵医嘱用药。实验组20例在对照组的基础上,应用颅内压监测仪,通过正确的使用颅内压监测仪,根据颅内压的数据,预先性的发现颅内压力的动态变化,指导临床用药,前瞻性的采取一系列干预颅内压增高的护理措施。结果 实验组患儿未出现病死情况（0）,对照组患儿出现2例死亡病例（10.00%）,两组比较差异有统计学意义（P〈0.05）;在再出血方面,实验组出现1例（5.00%）,对照组出现3例再出血（15.00%）,两组比较差异有统计学意义（P〈0.05）;实验组出现1例重残患儿（5.00%）,对照组出现4例重残患儿（20.00%）,两组比较差异有统计学意义（P〈0.05）;在住院天数方面,实验组平均住院天数为（9.4±3.4）d,明显低于对照组平均住院天数（16.5±5.8）d,两组比较差异有统计学意义（P〈0.05）。结论 对重型颅脑损伤患儿实施颅内压监护,有助于早期发现颅内压升高,指导医护人员进行及时处理,低病死率和并发症的发生率,值得临床推广应用。

Objective To investigate the effect and nursing methods of intracranial pressure monitoring in children with craniocerebral injury. Methods 40 children with craniocerebral injury from March 2011 to December 2015 cured in our hospital were selected and randomly divided into two groups, 20 cases were divided into control group and mainly treated with routine neurosurgery nursing, which monitored of vital signs by observing the change of consciousness, pupil and physical activity, and then prescribed medication. The other 20 cases were divided into experimental group and applied with intracranial pressure monitor, through the correct use of intracranial pressure monitor, according to the data of intracranial pressure, pre sexual found the dynamic changes of intracranial pressure, so as to guide the clinical medication, forward-looking taken a series of interventions for intracranial pressure increased nursing measures on the basis of routine nursing. Results The experimental group did not appear mortality （0） and the control group had 2 cases （10.00%）, and there were significant difference between the two groups （P〈0.05）. Experimental group accounted for 1 （5.00%） in rebleeding, the control group occurred in 3 cases of rebleeding （15.00%）, and there were significant difference between the two groups （P 〈 0.05）. Experimental group accounted for 1 case of severely disabled children （5.00%）, the control group had 4 cases of severely disabled children （20.00%）, and there were significant difference between the two groups （P 〈 0.05）. In the days of hospitalization, the average days of hospitalization of experimental group was （9.4＆#177;3.4）days, which was significantly lower than that of control group with （16.5＆#177;5.8） days, and there were significant difference between the two groups （P 〈 0.05）. Conclusion The implementation of intracranial pressure monitoring in patients with severe brain injury is helpful to the early detection of intracranial pressure, to guide medical personnel to timely treatment, it has low mortality and incidence of complications, and it is worthy of clinical popularization and application.