中医综合护理措施对脑积水术后神经功能恢复的影响

Effect of Chinese Medicine Comprehensive Nursing Measures for the Recovery of Neurological Function in Postoperative Hydrocephalus

目的:观察中医综合护理措施对脑积水术后神经功能恢复的影响。方法:将70例患者随机分为对照组34例和观察组36例;对照组术后行甘露醇注射液、单唾液酸四己糖神经节苷脂钠注射液、注射用鼠神经生长因子等治疗,并给予常规西医护理;观察组在对照组的基础上加用穴位贴敷、针刺和中医护理措施等综合调护方案;2组疗程均为14 d,分别于治疗后第1、7和14天进行格拉斯哥(GCS)评分、美国国立卫生研究院卒中量表(NIHSS)评分和脑积水程度评定(采用Huckman指数评价)。结果:神经功能恢复总有效率观察组为91.67%,对照组为73.53%;2组临床疗效经秩和检验,差异有统计学意义(P<0.05),观察组疗效优于对照组。治疗后第7、14天,2组GCS评分较治疗第1天明显升高(P<0.05),NIHSS评分较第1天明显下降(P<0.05);且观察组GCS、NIHSS评分改善较对照组更显著(P<0.05)。治疗第14天,观察组Huckman指数转常为97.22%,对照组为82.35%,2组比较,差异有统计学意义(P<0.05)。结论:穴位贴敷、针刺联合中医护理措施调护方案对脑积水术后患者神经功能恢复有良好作用,值得临床推广应用。

Objective:To observe the effect of Chinese medicine comprehensive nursing measures on the recovery of neurological function in postoperative hydrocephalus.Methods:Divided 70 cases of patients into the control group and the observation group randomly,34 cases in the control group and 36 cases in the observation group.The control group received such postoperative treatments as mannitol injection,monosialotetrahexosyl ganglioside sodium injection and mouse nerve growth factor for injection as well as routine western medicine nursing,while the observation group additionally received comprehensive regimens for regulating and nursing such as point-application,acupuncture and Chinese medicinenursing measures.The course of treatment in both groups lasted for 14 days.On the 1st,7 thand 14thdays of treatment,assessed the scores of Glasgow Coma Scale(GCS),the National Institutes of Health Stroke Scale(NIHSS)and the degree of hydrocephalus respectively.Results:The total effective rate of neurological functional recovery was 91.67%in the observation group and73.53%in the control group,difference being significant via rank sum test(P<0.05);the curative effect in the observation group was better than that in the control group.On the 7 thand 14thdays of treatment,the scores of GCS in both groups were significantly increased when compared with those on the 1stday of treatment(P<0.05),and the scores of NIHSS were significantly decreased when compared with those on the 1stday of treatment(P<0.05);the scores of GCS and NIHSS in the observation group were improved more significantly than those in the control group(P<0.05).On the 14thday of treatment,the rate of Huckman index back to norm was 97.22%in the observation group and 82.35%in the control group,difference being significant(P<0.05).Conclusion:Point application and acupuncture combined with regimens for regulating and nursing in Chinese medicine comprehensive nursing measures has good effect in promoting the recovery of neurological function in postoperative hydrocephalus,which is worthy of clinical promotion and application.