不同护理干预方法对清醒后重型颅脑损伤患者功能恢复的对比分析

目的 探讨不同护理干预方法对清醒后重型颅脑损伤患者功能恢复的对比分析。 方法 选择2011年7月-2015年2月在哈尔滨医科大学附属第一医院神经外科诊治的清醒后重型颅脑损伤患者120例,根据随机数字表法分为观察组与对照组各60例,对照组给予日常常规护理和单纯常规营养干预,观察组给予优质护理与基于益生菌的早期肠内营养干预,护理观察时间为14 d。 结果 2组护理后的日常生活能力(activity of daily living,ADL)评分与卡氏评分(Karnofsky performance status scale,KPS)都呈现明显上升的趋势(P<0.05),同时护理后观察组的ADL与KPS评分明显高于对照组(P<0.05)。护理期间观察组的肺部感染、血液感染、泌尿系统感染、伤口感染等并发症发生情况明显少于对照组(P<0.05)。2组护理后的IFN-γ含量明显上升,而IL-4含量明显下降,与护理前对比差异有统计学意义(P<0.05),同时组间对比差异也有统计学意义(P<0.05)。观察组的ICU住院时间及28 d病死率分别为(7.82±1.23) d和1.70%,而对照组分别为(11.94±2.91) d和10.00%,观察组的ICU住院时间及28 d病死率都明显少于对照组(P<0.05)。 结论 优质护理与基于益生菌的早期肠内营养干预在清醒后重型颅脑损伤患者中的应用可以提高机体细胞免疫功能,降低继发感染的发生率,有利于患者机体功能恢复,是减少死亡的重要手段。 

Comparative analysis of effective nursing intervention on functional recovery of patients with severe traumatic brain injury

Objective To investigate comparative effects of the functional recovery with different nursing interventions for the severe traumatic brain injury patients with sober. Methods We selected 120 sober patients of severe traumatic brain injury treated in our hospital from July,2011 to February,2015,and randomly divided into the observation group and the control group with equal subjects in each group.The control group was given daily routine care and simple routine nutrition intervention,while the observation group was given the quality care and early intestinal nutrition intervention based on probiotics,with 14 days of care and observation. Results The activity of daily living (ADL) and Karnofsky performance status scale (KPS) scores after care were shown clear upward trend (P<0.05),while the ADL and KPS scores after care in the observation group were significantly higher (P<0.05).The lung infection,blood infection,urinary tract infection,wound infection and other complications during the care in the observation group were significantly less than those in the control group (P<0.05).The IFN-γ contents after care in the two groups were significantly increased,while the IL-4 contents were significantly decreased (P<0.05),while differences between the two groups were statistically significant (P<0.05).The ICU stay time and 28 days hospital mortality rate in the observation group were (7.82±1.23) d and 1.7%,while the control group were (11.94±2.91) d and 10.0%,hence the ICU stay time and 28 days hospital mortality rate in the observation group were significantly lower than those in the control group (P<0.05). Conclusion The quality care and early intestinal nutrition intervention based on probiotics for sober patients with severe traumatic brain injury can improve immune function and reduce the incidence of secondary infection,help patients recover body functions,serving as an important tool to reduce death.