中华护理杂志 ›› 2016, Vol. 51 ›› Issue (1): 29-34.DOI: 10.376/j.issn.0254-1796.2016.01.006

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基于脑性昏迷患者感知水平的唤醒干预对其觉醒意识及预后的影响

  

  • 出版日期:2016-01-05 发布日期:2016-01-05

The impacts of nursing intervention based on level of perception on consciousness and prognosis in cerebral coma patients

  • Online:2016-01-05 Published:2016-01-05

摘要: 目的 探讨感知水平唤醒干预措施应用于脑性昏迷患者的效果。 方法 选取我院ICU于2010年3月至2014年2月收治的82例颅脑损伤伴重度脑性昏迷患者,根据诊治先后顺序进行分组,分别设为对照组(n=43)和实验组(n=39)。 对照组开展常规护理模式;实验组开展感知唤醒干预措施。 比较两组在不同时期的格拉斯哥昏迷评分(Glasgow Coma Score, GCS)、功能障碍评分(Dysfunction Score,DFS)、脑电图(Electroencephalogram,EEG)评分,并比较听觉脑干诱发电位潜伏期(auditory brainstem evoked potential,ABEP)、苏醒情况及意识状态。 结果 治疗2、3、4周末,实验组GCS及EEG评分均高于对照组(P<0.05),DFS评分低于对照组(P<0.05)。 治疗4周末,实验组ABEP绝对潜伏期及峰间潜伏期均短于对照组(P<0.01)。 实验组在1~10d、11~20d及21~30d苏醒率高于对照组(P<0.01),平均苏醒时间短于对照组(P<0.01),且苏醒总有效率高于对照组(P<0.01)。 结论 感知水平的唤醒干预措施应用于重度脑性昏迷患者,能改善其意识状况,并促进苏醒。

关键词: 感知水平; 脑性昏迷, 重度; 觉醒意识; 病情预后

Abstract: Objective To explore clinical effects of intervention on awakening of cerebral coma patients. Methods A total of 82 craniocerebral injured patients with severe cerebral coma were selected from March 2010 to February 2014. The control group(n=43) was provided routine nursing intervention,while the experimental group(n=39) was provided intervention based on level of perception. Glasgow coma score(GCS),dysfunction score(DFS),electroen- cephalogram(EEG) score,auditory brainstem evoked potential(ABEP) and state of consciousness of two groups were recorded and compared. Results At the end of 2,3 and 4 weeks after intervention,GCS and EEG scores of the experimental group were higher than those in the control group(P<0.05),and DFS score was lower than that of the control group (P<0.05). After 4 weeks’ intervention,both indicators of ABEP in the experimental group were shorter (P<0.05). Overall,in the experimental group,the rate of awakening was higher(P<0.05),the average days to achieve awakening were shorter(P<0.05),and the total efficiency of awakening was higher(P<0.05). Conclusion Awakening severe cerebral coma patients using intervention based on level of perception can effectively improve consciousness and promote prognosis.

Key words: Perception; Cerebral Coma, Severe; Awareness; Prognosis