早期康复护理干预对创伤性颅脑损伤患者神经、肢体运动及生活质量的影响

目的探讨早期康复护理干预对创伤性颅脑损伤患者的神经、肢体运动及生活质量的影响。方法选取2012年1月～2013年5月在杭州市萧山区中医院外科住院治疗的创伤性颅脑损伤患者84例。采用随机数字表将纳入的84例患者随机分为康复护理组（n=42）和常规护理组（n=42）。两组患者均予以保持呼吸道通畅、吸氧、控制颅内压、预防感染、营养脑细胞及对症支持治疗。常规护理组予以颅脑损伤常规护理,康复护理组予以早期康复护理干预,两组干预疗程均为4周。观察并比较两组患者干预前后神经、肢体运动及生活质量的变化。结果干预4周后,两组患者NIHSS评分[（21.06±4.31）、（16.72±3.87）分]均较干预前[（25.52±4.87）、（25.13±4.65）分]明显下降,Fugl-Meyer评分[（80.62±8.12）、（86.47±8.92）分]较干预前[（74.29±7.24）、（74.05±7.12）分]明显上升（P〈0.05或P〈0.01）,且康复护理组改善的幅度明显大于常规护理组（P〈0.05）;两组患者干预后日常生活、物质功能、社会功能和心理功能评分均较干预前明显改善（P〈0.05或P〈0.01）,且康复护理组改善幅度明显大于常规护理组（P〈0.05）。结论早期康复护理用于创伤性颅脑损伤患者可促进其脑功能的早期康复,改善神经及肢体运动功能,减少致残率,并可提高患者的生活质量,改善预后。

Influence of early rehabilitation nursing intervention on nerve,body movement and life quality of patients with traumatic brain injure

Objective To discuss the influence of early rehabilitation nursing intervention on nerve, body movement and life quality of patients with traumatic brain injure（TBI）. Methods 84 cases of patients with TBI, who were given the medical treatment in Surgery Department, Xiaoshan Hospital of Traditional Chinese Medicine in Hangzhou City from January 2012 to May 2013, were selected and divided into rehabilitation nursing group（n = 42） and routine nursing group（n = 42） by table of random number. The patients in the two groups were given maintenance of respiratory tract unobstructed, oxygen uptake, control of intracranial pressure（ICP）, infection prevention, brain cells nutrition and other symptomatic supporting medical treatment. The patients in routine nursing group were given routine nursing for brain injury, while the patients in rehabilitation nursing group were given early rehabilitation nursing intervention. The courses of intervention in the two groups were both 4 weeks. The changes of nerve, body movement and life quality of patients in two groups were observed and compared. Results After 4 weeks＇ intervention, the NIHSS scores [（21.06±4.31）,（16.72±3.87） scores] of patients in the two groups obviously declined, while the Fugl-Meyer scores [（80.62±8.12）,（86.47±8.92） scores] obviously rose than before [NIHSS scores：（25.52 ±4.87）,（25.13±4.65） score; Fugl-Meyer scores：（74.29±7.24）,（74.05±7.12） scores]（P〈0.05 or P〈0.01）, and the improvement degree of patients in rehabilitation nursing group was much higher than that in routine nursing group（P〈0.05）. The scores of daily life, material function,social function and psychological function of patients in two groups after intervention were improved than before（P〈0.05 or P〈0.01）, and the improvement degree of patients in rehabilitation nursing group was much higherthan that in routine nursing group（P〈0.05）. Conclusion The application of early rehabilitation nursing in patients with TBI