72例重型颅脑损伤患者预防上消化道出血的循证护理

目的探讨预防重型颅脑损伤患者消化道出血的循证护理方法。方法将142例重型颅脑损伤的患者按随机数字表法分为常规护理组（n=70）和循证护理组（n=72）。常规护理组采用神经外科常规护理,同时根据患者颅脑损伤严重程度,对重型颅脑损伤患者经验性预防使用抗生素、制酸剂、胃黏膜保护剂等;循证护理组则应用循证护理（包括深入理解上消化道出血的病生机制、查询循证资料、心理指导及宣传教育、饮食护理、早期护理干预等）。对2组患者上消化道出血发生率、病死率及治愈率进行比较。结果循证护理组并发上消化道出血6例,发生率为8.33%;常规护理组25例并发上消化道出血,发生率为35.71%,2组比较差异有统计学意义（P〈0.05）。常规护理组治愈率、病死率分别为68.57%及31.43%,循证护理组治愈率、病死率分别为77.78%及22.22%,2组治愈率、病死率比较差异均无统计学意义（均P〉0.05）。结论对重型颅脑损伤患者应用循证护理可以显著降低上消化道出血的发生率,具有重要的临床护理意义。

Evidence-based Nursing of 72 Patients with Severe Traumatic Brain Injury to Prevent Upper Gastrointestinal Bleeding

Objective To investigate the evidence-based nursing methods for patients with severe traumatic brain injury in order to prevent upper gastrointestinal bleeding.Methods A total of 142 patients with severe traumatic brain injury were randomly divided into two groups：evidence-based nursing group（72 cases） and conventional nursing group（70 cases）.Patients in conventional nursing group were routinely treated with drugs such as antibiotics,acid inhibitor and gastric mucosal protective agents according to the degree of brain injury.Patients in evidence-based nursing group were given evidence-based care,including data collection,pathophysiological understanding of upper gastrointestinal hemorrhage,psychological guidance and education,diet care,and early nursing intervention.The incidence of upper gastrointestinal bleeding,mortality and cure rate were compared between the two groups.Results The incidence of upper gastrointestinal bleeding in evidence-based nursing group was significantly lower than that in conventional nursing group（8.33% vs 35.71%,P0.05）.However,no significant differences in the mortality and cure rate were observed between the two groups（77.78% vs 68.57% and 22.22% vs 31.43%,respectively;P0.05）.Conclusion Evidence-based nursing can significantly reduce the incidence of upper gastrointestinal bleeding in patients with severe traumatic brain injury.