针对性护理对重型颅脑损伤行去骨瓣减压术患者预后的改善效果

The improvement effect of targeted nursing on the prognosis of patients with severe craniocerebral injury undergoing decompressive craniectomy

目的 分析针对性护理对重型颅脑损伤行去骨瓣减压术患者预后的改善效果。方法 选取2019年1月至2021年1月收治的60例行去骨瓣减压术治疗的重型颅脑损伤患者,采用抽签法将其随机分为对照组和试验组,各30例。对照组采取常规护理,试验组在常规护理的基础上采取针对性护理。比较两组的神经功能缺损、昏迷、疼痛程度,日常生活能力、运动功能、术后并发症发生情况,焦虑、抑郁程度及免疫指标。结果 干预14 d后,两组的NIHSS及FRS评分均降低,GCS评分升高,且试验组优于对照组(P<0.05)。干预14 d后,两组的Barthel与Fugl-Meyer评分均升高,且试验组高于对照组(P<0.05)。试验组的术后并发症总发生率为10.00%,低于对照组的26.67%,差异具有统计学意义(P<0.05)。干预14 d后,两组的HAMA与HAMD评分均降低,且试验组低于对照组(P<0.05)。干预14 d后,两组的CD4+及CD4+/CD8+均升高,CD8+降低,且试验组优于对照组(P<0.05)。结论 针对性护理在重型颅脑损伤去骨瓣减压术患者中的应用效果理想,可减轻昏迷、疼痛程度,保护神经功能,减少术后并发症的发生,缓解负性情绪,改善患者的免疫功能、日常生活能力及运动功能,具有较高的临床推广意义。

Objective To analyze the improvement effect of targeted nursing on the prognosis of patients with severe craniocerebral injury undergoing decompressive craniectomy.Methods Sixty patients with severe craniocerebral injury undergoing decompressive craniectomy from January 2019 to January 2021 were selected and randomly divided into control group and experimental group by drawing lots method,with 30 cases in each group.The control group was given conventional nursing,and the experimental group was given targeted nursing on the basis of conventional nursing.The degree of neurological deficit,coma,pain,ability of daily living,motor function,postoperative complications,degree of anxiety,depression and immune indexes were compared between the two groups.Results After 14 d of intervention,NIHSS and FRS scores decreased and GCS score increased in the two groups,and those in the experimental group were better than the control group(P<0.05).After 14 d of intervention,Barthel and Fugl-Meyer scores increased in both groups,and those in the experimental group were higher than the control group(P<0.05).The total incidence of postoperative complications in the experimental group was 10.00%,which was lower than 26.67% in the control group,and the difference was statistically significant(P<0.05).After 14 d of intervention,the HAMA and HAMD scores in the two groups decreased,and those in the experimental group were lower than the control group(P<0.05).After 14 d of intervention,CD4+and CD4+/CD8+increased and CD8+decreased in the two groups,and those in the experimental group were better than the control group(P<0.05).Conclusion Targeted nursing for patients with severe craniocerebral injury undergoing decompressive craniectomy has ideal application effect,it can reduce the degree of coma and pain,protect neurological function,reduce the occurrence of postoperative complications,alleviate negative emotions,and improve the immune function,ability of daily living and motor function,with high clinical significance.