弥漫性脑损伤合并二次损伤的护理干预

目的探讨弥漫性脑损伤合并二次损伤的护理干预。方法弥漫性脑损伤合并二次损伤患者20例（治疗组）和脑膜瘤择期手术患者（对照组）20例，动态监测脑组织氧分压、二氧化碳分压．pH值、脑温和细胞凋亡率的变化。结果治疗组氧分压（20．35±7．13）mmHg，明显低于对照组（39．9±3．94）mmHg（t=5．475，P=0．000）；治疗组二氧化碳分压（58．29±8．61）mmHg，明显高于对照组（43．90±1．57）mmHg（t=2．810，P=O．014）；治疗组脑温度（39．57±0．63）℃，明显高于对照组（37．26±0．31）℃；预后良好组脑组织二氧化碳分压（27．64±3．08）mmHg明显高于预后较差组（15．80±4．14）mmHg（f=5．475，P=0．000）；低氧血症、低血压、高热及电解质紊乱的护理干预可以降低病残率。结论弥漫性脑损伤合并二次损伤的护理干预能有效地改善病人的预后，提高生存质量。

Nursing Intervention of Diffuse Brain Injury with Secondary Injury

Objective To explore the nursing intervention of diffuse brain injury with secondary injury. Methods The diffuse brain injury patients with secondary injuries in treatment group （n=20）and meningiomas elective surgery patients in control group （n=20）,The changes of brain tissue of oxygen,carbon dioxide partial pressure,pH, brain temperature and apoptosis were determined. Results The treatment group （20.35 ± 7.13 ） mmHg significantly lower than the control group（39.9 ± 3.94）mmHg（ t = 5.475, P = 0.000）;Treatment group partial pressure of carbon dioxide （58.29 ± 8.61）mmHg significantly higher than that control group （43.90 ± 1.57）mmHg （t = 2.810,P = 0.014）; The brain temperature treatment group（39.57 ±0.63）℃ ,significantly higher（37.26 ± 0.31 ）℃; The good prognosis group brain tissue partial pressure of carbon dioxide （27.64 ± 3.08 ）mmHg significantly higher than the poor prognosis group （ 15.80 ± 4.14）mmHg （ t = 5.475, P = 0.000） ; Nursing intervention of hypo-xemia, low blood pressure,high fever and electrolyte disturbance can reduce the case remnant rate. Conclusion Nursing intervention can effectively improve the prognosis of patients,improve the quality of life in diffuse brain injury with secondary injury.