急性颅脑损伤患者术前血糖、生化及血气分析的临床观察与护理对策

目的探讨急性颅脑损伤患者术前血糖、血生化及血气分析的变化特点。方法急性颅脑损伤患者102例为观察组,同期择期行手术治疗的颅内肿瘤患者20例为对照组。所有患者入手术室后立即抽取足背动脉血测定血糖（Glu）、血乳酸（Lac）、Na^＋、K^＋、Ca^2＋浓度和血红蛋白、红细胞压积,并同步测定血气值,包括pH、PaCO2、PaO2、HCO3^-、剩余碱（BE）、氧饱和度（SatO2）。结果观察组102例中有92例患者至少存在1项以上指标异常,对照组20例中有3例至少存在1项以上指标异常,观察组发生率明显高于对照组（P〈0.01）。观察组患者血气分析结果显示,PaO2、SatO2和BE均低于对照组（P〈0.05）。电解质分析显示,观察组K^＋浓度明显低于对照组（P〈0.05）。Glu和Lac浓度均高于对照组（P〈0.01）。结论急性颅脑损伤患者术前通常存在血电解质、Glu、Lac以及血气等一系列的失衡,手术室护士应采取正确的护理措施,协助麻醉医生加强围手术期血电解质、Glu、Lac以及血气等指标的监测,并及时纠正其异常,以提高颅脑损伤患者的救治成功率。

Observation of Blood Glucose and Blood Biochemistry Indexes, Analysts of Blood Gas and Nurse Strategy before Surgery in Patients with Acute Craniocerebral Injury

Objective To explore the changes in blood glucose, blood biochemistry indexes and blood gas before the surgery in patients with acute craniocerebral injury. Methods The blood glucose, blood lactic acid, electrolyte, hemoglobin concentration, and hematocrit were determined and analysis of the blood gas were performed in 102 patients with acute craniocerebral injury and 20 patients with intracranial tumor serving as control before the surgery. Results Blood glucose and level of blood lactic acid were significantly higher, and PaO2, SatO2, base excess and concentration of blood K^＋ were significantly lower in the experimental group than those in the control group （P〈0.05）. Conclusion There were the disturbances of blood electrolyte, blood glucose, blood lactic acid, and acid-base balance were present in the patients with acute craniocerebral injury. The monitoring blood electrolyte, blood glucose and blood lactic acid, and blood gas analysis should be strengthened and their abnormality should be retrieved in time in order to improve the prognosis in the patients with acute craniocerebral injury.