刺激性护理干预对创伤性脑损伤昏迷病人促醒效果和神经功能恢复的影响

Influence of stimulating nursing intervention on arousal and recovery of neurological function in coma patients with traumatic brain injury

[目的]探讨刺激性护理干预对创伤性脑损伤昏迷病人促醒效果和神经功能恢复的影响。[方法]选择2013年5月—2015年5月我院收治的创伤性脑损伤昏迷病人78例,随机分成两组各39例。对照组行常规护理,研究组在常规护理基础上进行刺激性护理干预,比较两组病人清醒情况、神经功能恢复情况及预后情况等。[结果]研究组15d清醒25例,30d清醒37例,对照组15d清醒11例,30d清醒19例,两组比较差异有统计学意义(P<0.05);研究组清醒时间(21.09d±3.42d)短于对照组(29.48d±3.28d),两组比较差异有统计学意义(P<0.05);研究组治疗6周后Karnofsky评分为72.49分±6.41分,日常生活活动能力量表(ADL)评分为62.57分±5.80分,格拉斯哥昏迷指数(GCS)评分为9.94分±2.41分,对照组治疗6周后Karnofsky评分为60.93分±4.58分,ADL评分为47.61分±4.25分,GCS评分为7.76分±1.45分,两组比较差异均有统计学意义(P<0.05);研究组并发症发生率(5.13%)低于对照组(53.85%),两组比较差异有统计学意义(P<0.05)。[结论]创伤性脑损伤昏迷病人采用刺激性护理干预能促进神经功能恢复,缩短清醒时间,改善预后情况,降低并发症发生率。

Objective：To probe into the influence of stimulating nursing intervention on the arousal and the recovery of neurological function in coma patients with traumatic brain injury.Methods：A total of 78 coma patients with traumatic brain injury in our hospital from May 2013 to May 2015 were randomly divided into two groups,each with 39 cases.The control group received routine nursing care,the study group received on the basis of routine nursing care stimulating nursing intervention,the two groups of patients＇ awake,neurological function recovery and prognosis were compared.Results：In study group there were 25 cases in 15 d awake,and 30 d awake was 37 cases.In the control group there were 11 cases 15 d awake,and 30 d awake 19 cases,the difference between the two groups was statistically significant（P〈0.05）.Awake time of the study group（21.09 d±3.42 d）was shorter than the control group（29.48 d±3.28 d）,the difference between the two groups was statistically significant（P〈0.05）.The Karnofsky score of the study group was 72.49±6.41 after 6 weeks treatment,ADL score was 62.57±5.80,GCS score was 9.94±2.41.The Karnofsky score in control group after 6 weeks treatment was 60.93±4.58,ADL score was 47.61±4.25,GCS score was 7.76±1.45,the difference between the two groups was statistically significant（P〈0.05）.The incidence of complications in the study group （5.13%）was lower than that in the control group（53.85%）,the difference between the two groups was statistically significant（P〈0.05）.Conclusions：Traumatic brain injury coma patients with stimulating nursing intervention could improve the recovery of nerve function,shorten the waking time,improve the prognosis and reduce the incidence of complications.