前瞻性护理干预对蛛网膜下腔出血手术患者康复的影响
彭 敏,张慧媛,康飞飞
(南昌大学第二附属医院,江西 南昌 330600)
摘要 目的:观察前瞻性护理对蛛网膜下腔出血手术患者康复的影响。 方法:选取 82 例蛛网膜下腔出血患者,按照随机数字表法将其分为对照组和观察组,每组 41 例。 对照组实施常规护理,观察组在对照组基础上实施前瞻性护理干预。 比较两组护理前及护理后康复情况[格拉斯哥昏迷评分(GCS)、美国国立卫生研究院卒中量表(NIHSS)评价意识及神经功能恢复]、住院时间、住院费用及并发症发生率。 结果:护理后,两组 GCS 评分均高于护理前,NIHSS 评分均低于护理前,且观察组GCS 评分高于对照组,NIHSS 评分低于对照组,以上差异均具有统计学意义(P<0.05);观察组住院时间短于对照组,住院费用低于对照组,差异均具有统计学意义(P<0.05);与对照组相比,观察组并发症发生率低(P<0.05)。 结论:前瞻性护理可促进蛛网膜下腔出血手术患者康复进程,改善患者意识及神经功能障碍,降低并发症发生率。
关键词: 蛛网膜下腔出血;前瞻性护理;康复进程;并发症
中图分类号:R743.35 文献标志码:A 文章编号:1008-2409(2022)03-0094-05
Effect of prospective nursing intervention on rehabilitation of patients with subarachnoid hemorrhage
PENG Min, ZHANG Huiyuan, KANG Feifei.(The 2 nd Affiliated Hospital of Nanchang University, Nanchang 330600, China)
Abstract Objective: To observe the effect of prospective nursing on the rehabilitation of patients with subarachnoid hemorrhage. Methods: A total of 82 patients with subarachnoid hemorrhage were randomized into the control group and observation group, each with 41 cases. The control group underwent routine nursing, while the observation group accepted prospective nursing intervention on the basis of the control group. The pre-nursing and post-nursing recovery[Glasgow Coma Score(GCS)and National Stroke Scale (NIHSS)for consciousness and neurological function recovery], length of hospital stay, hospitalization costs and incidence of complications were compared between the two groups. Results: After nursing, GCS score of the two groups was higher than that before nursing, NIHSS score was lower than that before nursing, while GCS score of the observation group was higher than that of the control group, NIHSS score was lower than that of the control group, which were of statistical differences(P<0.05); the hospitalization time of observation group was shorter than that of control group, and the hospitalization costs was lower than that of control group, and the difference was significant(P<0.05); compared with the control group, the complication rate of the observation group was lower(P<0.05). Conclusion: Prospective nursing can promote the rehabilitation process of patients with subarachnoid hemorrhage, improve their consciousness and neurological dysfunction, and reduce the incidence of complications.
Keywords: subarachnoid hemorrhage; prospective nursing; rehabilitation process; complications
参考文献:
[1] 秦超,刘竞丽.蛛网膜下腔出血的诊断与治疗[J].中华神经科杂志,2020,53(10):814-818.
[2] 曾湖,徐立新,陈华,等.动脉瘤性蛛网膜下腔出血患者围手术期内并发医院感染风险列线图模型的构建与验证[J].中国脑血管病杂志,2021,18(10):679-688,723.
[3] 陈美美,杨育,陈蓓妮,等.临床路径护理对动脉瘤性蛛网膜下腔出血介入手术病人快速康复的效果评价[J].中国微侵袭神经外科杂志,2018,23(10):479-480.
[4] 吉润芷,王艳,王鹿婷,等.前瞻性护理在高血压性脑出血偏瘫病人中的应用[J].中国临床神经外科杂志,2020,25(9):635-636.
[5] PETROIANU G,OSSWALD P M.Glasgow coma scale(GCS)[M].Springer Berlin Heidelberg,2000:269-270.
[6] 侯东哲,张颖,巫嘉陵,等.中文版美国国立卫生院脑卒中量表的信度与效度研究[J].中华物理医学与康复杂志,2012,34(5):372-374.
[7] 王航,宋歌,谢万福.早期脑血流量检测在预测蛛网膜下腔出血迟发性脑缺血患者预后的作用研究[J].国际神经病学神经外科学杂志,2018,45(2):128-132.
[8] 李维国,申立波,李俊岭,等.腰大池持续外引流治疗动脉瘤性蛛网膜下腔出血的临床疗效及对认知障碍和脑血管痉挛并发症的影响[J].中国医师杂志,2018,20(4):574-576.
[9] 梁莹,吴培.细节护理对蛛网膜下腔出血病人肺部感染及预后的影响[J].中国临床神经外科杂志,2020,25(5):323-324.
[10] 陈华利,范海燕,李翠华,等.前瞻性针对护理对脑出血偏瘫患者独立生活能力与神经功能的影响[J].河北医药,2019,41(2):314-317.
[11] 刘丽丽,任海燕,钱自春,等.前瞻性护理对脑卒中偏瘫患者下肢深静脉血栓发生率的影响[J].当代护士(中旬刊),2018,25(11):23-25.
[12] 水涛,郭再玉,张国哲,等.亚低温对重症蛛网膜下腔出血后脑血流速和脑氧摄取率的影响和意义[J].中华医学杂志,2018,98(19):1489-1492.
[13] 杨莹,李肖肖,官彦雷.头部亚低温护理对蛛网膜下腔出血术后的影响[J].中国医科大学学报,2018,47(1):88-90.
[14] 曹卓,郑秉杰.持续早期综合护理干预在蛛网膜下腔出血后早期脑损伤患者中的应用[J].实用医学杂志,2018,34(17):2968-2970.
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