多感官促醒干预对高血压性脑出血术后昏迷患者神经功能及感官康复的影响

Influence of multisensory awakening intervention on neurological function and sensory rehabilitation in coma patients after hypertensive intracerebral hemorrhage

目的:分析在高血压性脑出血术后昏迷患者护理中多感官促醒护理干预对苏醒时间、神经功能与感官恢复效果的影响。方法:回顾性分析2019年1月至2021年12月于本院重症监护室接受治疗的90例高血压性脑出血术后昏迷患者临床资料,依据采取的护理方案分为对照组与观察组,每组各45例。对照组执行传统护理,观察组使用多感官促醒护理干预,统计并比较两组患者的苏醒时间段(≤14d、15~28d、>28d)分布情况、护理前后不同时间段(护理前、护理7d、护理14d、护理28d)的神经功能评分(美国国立卫生院卒中量表评分)、脑功能状态评分(Grant氏二分法变量评分)差异。结果:观察组苏醒时间分布中≤14d占比高于对照组,15~28d占比、>28d占比低于对照组,差异有统计学意义(P<0.05);护理前两组患者的美国国立卫生院卒中量表评分、Grant氏二分法变量评分比较,差异无统计学意义(P>0.05),护理7d、护理14d、护理28d的美国国立卫生院卒中量表评分均呈下降趋势,Grant氏二分法变量评分均呈上升趋势,且观察组各时间段的美国国立卫生院卒中量表评分低于对照组,Grant氏二分法变量评分高于对照组,差异有统计学意义(P<0.05)。结论:在高血压性脑出血术后昏迷患者护理工作中使用多感官促醒护理干预,既可以缩短其苏醒时间,又能够下调美国国立卫生院卒中量表评分、提升Grant氏二分法变量评分,促使患者从中获得更大的收益。

Objective:To analyze the effect of multi-sensory wake-up nursing intervention on wake-up time,neurological function and sensory recovery effect in the nursing of coma patients after hypertensive intracerebral hemorrhage.Methods:The clinical data of 90 postoperative coma patients with hypertensive intracerebral hemorrhage who were treated in the intensive care unit of our hospital from January 2019 to December 2021 were retrospectively analyzed.According to the nursing plan,they were divided into the control group and the observation group,with 45 cases in each group.The control group was given traditional nursing,and the observation group was given multi-sensory wake-up nursing intervention.The distribution of the wake-up time period(≤14d,15~28d,>28d)of the two groups of patients,different time periods before and after nursing(before nursing,nursing 7d,14d of nursing,28d of nursing)of neurological function score(National Institutes of Health Stroke Scale score),brain function status score(Grant's dichotomous variable score)difference were statistically compared between the two groups.Results:The proportion of wake-up time≤14d in the observation group was higher than that in the control group,the proportion of 15~28d and the proportion>28d in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the scores of hospital stroke scale and Grant's dichotomous variable score(P>O.05).The scores of the National Institutes of Health Stroke Scale at 7 days of nursing,14 days of nursing and 28 days of nursing all showed a downward trend,and Grant's dichotomy score of the method variables showed an upward trend,and the scores of the National Institutes of Health Stroke Scale in the observation group were lower than those of the control group,and the scores of the Grant's dichotomous variables were higher than those of the control group,and the differences were statistically significant(P<0.05).Conclusion:The use of multi-sensory wakeup nursing intervention in the nursing work of coma patients after hypertensive intracerebral hemorrhage can not only shorten their wake-up time,but also reduce the score of the National Institutes of Health Stroke Scale and improve the score of Grant's dichotomous variable,which can promote patients get more benefit from it.