围术期预见性护理干预对颅脑创伤后患者血清炎性因子水平的影响

Eff ect of perioperative predictive nursing intervention on serum infl ammatory factors in patients after craniocerebral trauma

目的探讨围术期预见性护理干预措施对颅脑创伤后患者血清炎性因子水平的影响。方法选取2019年11月—2020年11月医院接受治疗的颅脑损伤患者92例为研究对象,根据患者接受护理措施差异分为观察组和对照组,每组46例。观察组给予围术期预见性护理,对照组进行常规护理。对患者入院第1天(T1)、第3天(T2)以及第7天(T3)的血清炎性因子白细胞介素-6(IL-6)、肿瘤坏死因子(TNF-α)、髓过氧化物酶(MPO)及降钙素原(PCT)进行监测,观察其动态变化过程,分析血清炎性因子与GCS评分的相关性,同时给予围术期预见性护理措施比较不同时段患者血清炎性因子水平变化情况,观察护理效果。结果各时段患者血清炎性因子与患者GCS评分线性回归分析结果显示,T1时段,患者TNF-α、MPO、PCT与患者GCS评分呈现相关性(P<0.05);T2时段,患者TNF-α、MPO、PCT与患者GCS评分呈现相关性(P<0.05);T3时段,IL-6、PCT与患者GCS评分呈现相关性(P<0.05)。双因素方差分析结果显示,两组T1、T2、T3三个时间点IL-6、TNF-α、MPO以及PCT水平均先升高后下降,时间之间差异有统计学意义(P_(时间)<0.05);且观察组T1、T2、T3三个时间点IL-6、TNF-α、MPO以及PCT水平均低于对照组,组间之间差异有统计学意义(P_(组间)<0.05);并且随观察时间延长,组间差异逐渐增大,差异有统计学意义(P_(交互)<0.05)。观察组护理效果高于对照组,差异具有统计学意义(P<0.05)。结论颅脑损伤患者在出现损伤后,其体内血清炎性因子水平会明显提高,同时炎性因子与患者GCS评分在不同时段都表现出一定相关性。针对颅脑损伤患者给予科学的预见性护理工作能有效缓解患者炎症反应,保证其神经组织功能正常,促进其康复。

Objective To explore the eff ect of perioperative predictive nursing intervention on serum infl ammatory factors in patients after craniocerebral trauma.Methods A total of 92 patients with craniocerebral injury treated in the hospital from November 2019 to November 2020 were selected as the research objects.According to the differences in nursing measures received by the patients,they were divided into an observation group and a control group,with 46 cases in each group.The observation group was given perioperative predictive nursing,the control group was given routine nursing.The serum infl ammatory factors interleukin-6(IL-6),tumor necrosis factor(TNF-α),myeloperoxidase(MPO)and procalcitonin(PCT)were monitored on the fi rst day(T1),the third day(T2)and the seventh day(T3)of the patients,and their dynamic changes were observed.The correlation between serum infl ammatory factors and GCS score was analyzed,and perioperative predictive nursing measures were given to compare the changes of serum infl ammatory factors in diff erent periods of time,and observe the nursing eff ect.Results The linear regression analysis between serum infl ammatory factors and GCS score showed that TNF-α,MPO,PCT were correlated with GCS score in T1 period(P<0.05).At T2 period,TNF-α,MPO,PCT were correlated with GCS score(P<0.05).At T3,IL-6 and PCT were correlated with GCS score(P<0.05).The results of two-way analysis of variance showed that the levels of IL-6,TNF-α,MPO and PCT in the two groups at T1,T2 and T3 were increased fi rst and then decreased,and the diff erences between the time points were statistically signifi cant(P<0.05).The levels of IL-6,TNF-α,MPO and PCT in the observation group at T1,T2 and T3 were lower than the control group,the diff erences between the two groups were statistically signifi cant(P<0.05).With the extension of observation time,the diff erence between groups gradually increased,the diff erence was statistically signifi cant(P<0.05).The nursing eff ect of observation group was higher than that of control group,and the diff erence was statistically signifi cant(P<0.05).Conclusion The level of serum infl ammatory factors in patients with craniocerebral injury was signifi cantly increased after injury,and there was a certain correlation between infl ammatory factors and patients'GCS score in diff erent periods.Scientifi c predictive nursing for patients with craniocerebral injury can eff ectively relieve the infl ammatory reaction of patients,protect the normal function of their nervous tissue,and promote their rehabilitation.