多感觉联合刺激护理对重症颅脑损伤昏迷患者苏醒、神经功能及并发症的影响

Effect of multi-sensory stimulation nursing on recovery,neurological function,and complications of coma patients with severe traumatic brain injury

目的:探讨多感觉联合刺激护理对重症颅脑损伤(severe traumatic brain injury,STBI)昏迷患者苏醒、神经功能及并发症的影响。方法:选取2018年3月至2022年3月皖西卫生职业学校附属医院神经外科收治的150例STBI昏迷患者为研究对象。按照随机数字表法将患者简单随机分为对照组与观察组,每组各75例。对照组实施常规治疗和护理,观察组在常规治疗和护理基础上采用多感觉联合刺激。2组均干预30 d,比较2组苏醒情况、干预30 d后神经功能[格拉斯哥昏迷量表(Glasgow Coma Scale,GCS)和国际改良版昏迷恢复量表(Coma Recovery ScaleRevised,CRS-R)]、脑电图synek分级情况及干预期间并发症情况。结果:观察组干预30 d苏醒率为66.67%,明显高于对照组的39.73%(P<0.05);观察组苏醒时间为(17.85±4.15) d,短于对照组的(24.85±5.68) d(P<0.05)。干预30 d后,观察组GCS及CRS-R评分均高于对照组(均P<0.05),且观察组synek分级为I级的占比为38.39%,明显高于对照组的21.92%(P<0.05)。干预期间,观察组总并发症发生率为9.72%,低于对照组的21.92%(P<0.05)。结论:多感觉联合刺激能促进STBI昏迷患者苏醒,有利于改善脑电图synek分级,恢复神经功能,并降低并发症发生率。

Objective:To investigate the effect of multi-sensory stimulation nursing on recovery,neurological function and complications of coma patients with severe traumatic brain injury(STBI).Methods:A total of 150 STBI coma patients admitted to the Department of Neurosurgery of Affiliated Hospital of Wanxi Health Vocational School from March 2018 to March 2022 were selected as research subjects. Using to the random number table method, the patients were randomly divided into a control group and an observation group, each group with 75 cases. The control group received routine treatment and nursing, while the observation group received multi-sensory stimulation on the basis of routine treatment and nursing. The recovery, neurological function [Glasgow Coma Scale (GCS) and Coma Recovery Scale Revised (CRS-R)], electroencephalogram synek grading, and complications after 30 d of intervention were compared between the 2 groups. Results: The 30-d recovery rate of the observation group was 66.67%, which was significantly higher than 39.73% of the control group (P<0.05);the recovery time of the observation group was (17.85±4.15) d, which was shorter than (24.85±5.68) d of the control group (P<0.05). After 30 d of intervention, GCS and CRS-R scores in the observation group were higher than those in the control group (both P<0.05), and the proportion of synek grade I in the observation group was 38.39%, which was significantly higher than 21.92% in the control group (P<0.05). During the intervention, the total incidence of complications in the observation group was 9.72%, which was lower than 21.92% in the control group (P<0.05). Conclusion: Multisensory combined stimulation can promote the recovery of STBI coma patients, improve electroencephalogram synek classification, restore neurological function, and reduce the incidence of complications.