护理干预对颅脑外伤保守治疗期间合并大面积脑梗死患者并发症及预后的影响

目的：探讨护理干预对于颅脑外伤保守治疗期间发生大面积脑梗死相关并发症及预后的影响，为临床护理提供相关依据。方法采用回顾性研究方法，选择2009年3月-2013年3月本院收治颅脑外伤患者接受保守疗法期间发生大面积脑梗死患者48例，根据是否给予护理干预分为常规组和干预组，对并发症发生及预后进行对比分析。结果常规组病死率26．67％，干预组21．21％，差异无统计学意义（χ2＝0．987，P ＞0．05）；常规组出院时格拉斯哥预后评分（3．02±0．75）分，干预组（3．06±0．82）分，差异无统计学意义（t＝-0．161，P＞0．05）；干预组发生癫痫3例，下肢静脉血栓2例，肺部感染2例，均低于常规组，差异有统计学意义（χ2分别为4．364，6．158，4．003；P＜0．05）。结论对颅脑损伤保守治疗期间发生大面积脑梗死患者，护理干预可以减少癫痫发作、下肢静脉血栓及肺部感染等并发症的发生；有效的护理干预，是改善大面积脑梗死患者并发症的关键。

Effect of nursing intervention on complication and prognosis of patients with massive cerebral infarction during conservative treatment for traumatic brain injury

Objective To explore the effects of nursing intervention on complication and prognosis of patients with massive cerebral infarction （MCI） during conservative treatment for traumatic brain injury （TBI） so as to provide related basis for clinical nursing .Methods Forty-eight TBI patients with MCI from March 2009 to March 2013 were retrospectively analyzed and divided into the control group and the intervention group .The control group received the routine nursing , and the intervention group received the nursing intervention .The incidence of complication and the prognosis were compared between two groups .Results The mortality of patients in the control group was 26.67%, and was 21.21% in the intervention group , and the difference was not statistically significant （χ2 =0.987,P〉0.05）.The score of glasgow outcome scale （GOS） in the control group was （3.02 ±0.75） at the time of discharge, and was （3.06 ±0.82） in the intervention group, and the difference was not statistically significant （t=-0.161,P〉0.05）.The cases of the occurrence of epilepsy , venous thrombosis and pulmonary infection were respectively 3, 2, 2 cases in the intervention group , and were lower than those in the control group , and the differences were statistically significant （χ2 =4.364, 6.158, 4.003, respectively;P 〈0.05）.Conclusions The nursing intervention in MCI patients during conservative treatment for traumatic brain injury can reduce the incidence of complications including epilepsy , venous thrombosis and pulmonary infection .The effective nursing intervention is the key to improve the complications in MCI patients .