基于循证理论的精细化护理联合颅内压监测在重型颅脑损伤患者术后并发症预防中的效果

Prevention effect of fine nursing based on evidence-based theory combined with intracranial pressure monitoring on postoperative complications in patients with severe brain injury

目的探讨基于循证理论的精细化护理联合颅内压(ICP)监测在重型颅脑损伤(SBI)患者术后并发症预防中的效果。方法选取2020年1月至2022年6月鹰潭市人民医院收治的69例SBI患者,采用奇偶数随机分组法分为对照组(n=34)和干预组(n=35)。对照组予以常规护理,干预组在对照组的基础上予以基于循证理论的精细化护理联合ICP监测。比较干预后术后并发症发生情况、干预前后ICP及预后情况。结果干预后,干预组的并发症总发生率低于对照组,差异有统计学意义(P<0.05);两组术前及术后1、3、7、10 d的ICP的组间、时点和交互比较,差异有统计学意义(P<0.05),且干预组术后1、3、7、10d的ICP低于对照组,差异有统计学意义(P<0.05)。干预后,干预组预后不良率低于对照组,差异有统计学意义(P<0.05)。干预后,干预组格拉斯哥预后量表(GOS)评分高于对照组,差异有统计学意义(P<0.05)。结论基于循证理论的精细化护理联合ICP监测应用于SBI患者可以降低术后并发症总发生率,改善ICP水平和预后。

Objective To explore the prevention effect of fine nursing based on evidence-based theory combined with intracranial pressure(ICP)monitoring on postoperative complications in patients with severe brain injury(SBI).Methods A total of 69 patients with SBI admitted to Yingtan People's Hospital were enrolled between January 2020 and June 2022.According to random odd-even grouping method,they were divided into control group(n=34)and intervention group(n=35).The control group was given routine nursing,while intervention group was additionally given fine nursing based on evidence-based theory combined with ICP monitoring.The occurrence of postoperative complications after intervention,ICP and psychological state before and after intervention,and prognosis after intervention were compared.Results After intervention,the total incidence of complications in intervention group was lower than that in control group,the difference was statistically significant(P<0.05).Before surgery and at 1,3,7 and 10 d after surgery,there were significant differences in ICP between the two groups(P<0.05).At 1,3,7 and 10 d after surgery,ICP in intervention group was lower than that in control group,the difference was statistically significant(P<0.05).After intervention,poor prognosis rate in intervention group was lower than that in control group,the difference was statistically significant(P<0.05).The score of Glasgow outcome scale(GOS)was higher than that in control group,the difference was statistically significant(P<0.05).Conclusion Fine nursing based on evidence-based theory combined with ICP monitoring can reduce the incidence of postoperative complications,improve ICP and prognosis of patients with SBI.