重度颅脑损伤患者84例集束化护理效果研究

The effect of cluster nursing for 84 patients with severe head injury

目的探讨集束化护理对重度颅脑损伤患者的临床护理效果。方法选取2016年1月至2016年12月本院收治的84例重度颅脑损伤患者,根据随机数字表将患者分为观察组(n=42)及对照组(n=42),对照组应用常规性护理干预,观察组应用集束化护理,观察两组患者干预前、干预后肠功能障碍评分、血浆D-乳酸水平及营养状况变化,记录两组预后情况。结果观察组入院后第7天肠功能障碍评分、慢性健康状况评分系统(APACHEⅡ)、血浆D-乳酸水平均低于对照组(P<0.05)。观察组干预后血红蛋白(Hb)、血清白蛋白(ALB)、前蛋白(PA)水平均高于对照组(P<0.05)。观察组患者胃肠功能紊乱、死亡率低于对照组(P<0.05),而入住ICU时间、机械通气时间、平均住院时间短于对照组(P<0.05)。结论集束化护理能有效改善重度颅脑损伤患者胃肠功能及营养状况,有助于预防胃肠功能障碍的发生,改善患者预后。

Objective To investigate the effect of cluster nursing for patients with severe head injury.Methods 84 cases of patients with severe traumatic brain injury were divided into observation group（n=42）and control group（n=42）from January 2016 to December 2016.The control group were applicated with routine nursing intervention and observation group were applicated with cluster nursing.The levels of intestinal dysfunction score,D-change in plasma lactate and nutritional status of two groups before and after intervention were compared.Results The levels of dysfunction score,APACHE Ⅱscore,D-plasma lactate after 7 days of the admission to hospital were lower than the control group（P〈0.05）.The levels of hemoglobin（Hb）,serum albumin（ALB）,precursor protein（PA）of observation group after intervention were higher than the control groups（P〈0.05）.The gastrointestinal disorders,mortality rate of observation group were lower than the control group（P〈0.05）.The ICU stay time,duration of mechanical ventilation,the average length of hospital stay of the observation group were shorter than the control group（P〈0.05）.Conclusion The cluster nursing can improve gastrointestinal function and severe brain injury patients nutritional status,help prevent the incidence of gastrointestinal dysfunction and improve the prognosis.