多感官促醒护理模式对高血压脑出血术后昏迷患者觉醒意识及神经功能的影响

Effect of multi-sensory awakening nursing model on consciousness and nerve function of coma patients after operation of hypertensive cerebral hemorrhage

目的探讨多感官促醒护理模式对高血压脑出血术后昏迷患者觉醒意识及神经功能的影响。方法收集郑州大学第二附属医院2016-01—2018-12治疗的高血压脑出血术后昏迷患者130例,随机分为常规护理组和多感官促醒护理组。比较2组患者护理干预前后昏迷情况、生理状态、脑功能恢复情况、平均苏醒时间、并发症发生率。结果干预前及干预1周,常规护理组和多感官促醒护理组GCS评分、DFS评分、脑功能评分比较差异无统计学意义(P>0.05);干预2周和干预4周,常规护理组和多感官促醒护理组GCS评分和脑功能评分均较干预前明显升高,DFS评分明显降低,差异有统计学意义(P<0.05)。干预2周和干预4周,多感官促醒护理组GCS评分和脑功能评分均较常规护理组明显升高(分别为2周:9.42±1.43 vs 7.82±1.34,5.99±1.23 vs 3.59±0.63;4周:10.96±2.48 vs 8.95±1.46,9.72±1.48 vs 5.96±1.03),DFS评分较常规护理组明显降低(分别为2周:11.04±1.97 vs 14.98±2.39;4周:6.25±1.32 vs 9.82±2.03),差异均有统计学意义(P<0.05);多感官促醒护理组平均苏醒时间为(19.89±1.96)d,常规护理组平均苏醒时间为(29.08±2.87)d,多感官促醒护理组平均苏醒时间明显短于常规护理组,差异有统计学意义(t=-21.117,P<0.05)。多感官促醒护理组并发症发生率明显低于常规护理组(4.4%vs 17.7%),差异有统计学意义(χ^(2)=5.997,P<0.05)。结论多感官促醒护理干预通过听觉、嗅觉、视觉、触觉等多重感官刺激,促进高血压脑出血术后昏迷患者脑神经功能恢复,尽快苏醒,降低并发症发生率,且该方法简单易行。

Objective To explore the effect of multi-sensory awakening nursing model on consciousness and nerve function of coma patients after hypertensive cerebral hemorrhage operation.Methods 130 patients with coma after operation of hypertensive ce⁃rebral hemorrhage from Jan.2016 to Dec.2018 in the Second Affiliated Hospital of Zhengzhou University were collected.According to different nursing methods,the patients were divided into routine nursing group and multi-sensory awakening nursing group.The co⁃matose state,physiological state,recovery of brain function,average recovery time and complication rate were compared between the two groups.Results There was no significant difference in GCS score,DFS score,and brain function score between the conventional nursing group and the multisensory wake-up nursing group before the intervention and 1 week(P>0.05);the intervention was 2 weeks and the intervention 4 weeks,the conventional nursing group and The GCS score and brain function score of the multi-sensory wake-up nursing group were significantly higher than those before the intervention,and the DFS score was significantly reduced,and the difference was statistically significant(P<0.05).After 2 weeks of intervention and 4 weeks of intervention,the GCS score and brain function score of the multisensory awakening nursing group were significantly higher than those of the conventional nursing group(2 weeks:9.42±1.43 vs 7.82±1.34,5.99±1.23 vs 3.59±0.63;4 weeks:10.96±2.48 vs 8.95±1.46,9.72±1.48 vs 5.96±1.03),the DFS score was significantly lower than that of the conventional care group(2 weeks:11.04±1.97 vs 14.98±2.39;4 weeks:6.25±1.32 vs 9.82±2.03),the difference was statistically significant(P<0.05);the average wake-up time of the multi-sensory wake-up nursing group was(19.89±1.96)days,and the average wake-up time of the conventional care group was(29.08±2.87)days,and the multi-sensory wake-up treatment group The average wake-up time of the waking care group was significantly shorter than that of the conventional care group,and the difference was statistically significant(t=-21.117,P<0.05).The incidence of complications in the multisensory wake-up nursing group was significantly lower than that in the conventional nursing group(4.4%vs 17.7%),and the dif⁃ference was statistically significant(χ^(2)=5.997,P<0.05).Conclusion The multi-sense nursing intervention can promote the recovery of cerebral nerve function of comatose patients after operation of hypertensive cerebral hemorrhage by multi-sense stimulation such as sense of hearing,sense of smell,sense of vision,sense of touch,and so on,the method is simple and easy to use,and it is worthy to be widely used in clinical delivery.