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急性完全性颈髓损伤血压、心率异常变化的护理研究
引用本文:丁俊琴,马惠敏,井永敏,李秀婷,崔怡.急性完全性颈髓损伤血压、心率异常变化的护理研究[J].护士进修杂志,2010,25(16):1454-1456.
作者姓名:丁俊琴  马惠敏  井永敏  李秀婷  崔怡
作者单位:河北医科大学第三医院,河北,石家庄,050051
摘    要:目的分析急性完全性颈髓损伤患者血压、心率变化情况,为正确指导临床治疗和护理提供理论依据。方法选择急性完全性颈髓损伤患者97例为观察组,同期住院的颈椎骨折无颈髓损伤患者100例为对照组。并调查完全性颈髓损伤伴有高热或低氧血症时心率情况。分析急性完全性颈髓损伤患者血压、心率变化及其发生时段,并与颈椎骨折非颈髓损伤患者比较;观察患者在高热、缺氧时心率变化情况。结果观察组较对照组血压、心率明显降低(P0.05),观察组中血压下降、心率减慢的发生率明显高于对照组(P0.01),观察组中两周前和两周后血压、心率降低发生率差异有显著意义(P0.01);观察组中体温≥39℃时心率为(82.35±4.67)次/min,PO2≤60mmHg(SPO_20.90)心率为(86.36±8.23)次/min。结论急性完全性颈髓损伤后大多数患者在2周内出现血压下降、心率减慢;当伴发高热、缺氧时机体循环系统代偿能力差,心率增快不明显,易发生重要脏器缺血缺氧。

关 键 词:颈脊髓损伤  血压  心率  护理

Nursing research for change in blood pressure and heart rate abnormalities for patients with acute complete spinal cord injury
Institution:Ding Junqin,Ma Huimin,Jin Yongmin,etc(Nursing Depantment,The Third Hospital of Hebei Medical University,Shijiazhuang050051)
Abstract:Objective To observe and assess the change in blood pressure and heart rate for patients with acute complete cervical spinal cord injury(CSCI),and to provide theoretical basis for clinical treatment and nursing.Method 9 patients with acute complete spinal cord injury were selected as study group.100 subjects with cervical vertebrae fracture without paralysis as contrast group.The heart rate of patient with complete cervical spinal cord injury combined with high fever or hyoxemia.Blood pressure and heart rate changes in complete cervical spinal cord injury patients and its occurrence time were observed.Patient who have high fever heart or hyoxemia rate changes was observed and compared.Result There was significant difference in decrease of heart rate and blood pressure in study group compared with that in control group(P0.05),and the rate who have lower heart rate and blood pressure in study group have significant increase(P0.01).the rate of blood pressure and hyoxemia in study group have significant difference within 2 weeks and after 2 weeks(P0.01).In study group,the patients with temperature≥ 39℃,the heart rate is(82.35±4.67)beats/min,PO2≤60mmHg(SPO_20.90,the heart rate is(86.36± 8.23)beats/min Conclusion Most CSCI have decreased blood pressure and heart rate within 2 weeks,when company with high fever or oxygen deficiency,circulation have a poor compensatory ability,prone to ischemia and hypoxia in vital organs.
Keywords:Spinal cord injury Blood pressure Heart rate Nursing
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