Observation and countermeasure of perioperative nursing for patients with severe craniocerebral injury
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摘要: 目的 总结对重型颅脑损伤患者围术期主要护理措施及其临床效果,探讨可供临床借鉴的护理经验。 方法 回顾性分析绍兴市人民医院2015年6月-2016年6月收治的79例重型颅脑损伤患者的临床资料。患者均经颅内血肿开颅清除术,围术期经专业化护理,护理措施包括手术前后心理护理、特别护理(对症护理,预防并发症,应急护理)、术后康复训练。考察经临床治疗和护理干预后的治疗总有效率、卡氏功能状态评分(KPS)、日常生活能力评分、并发症发生率。 结果 治疗前KPS评分为(62.3±5.1)分,日常生活能力评分为(52.3±6.0)分;治疗后KPS评分为(86.8±6.9)分,日常生活能力评分为(52.3±6.0)分;治疗后KPS评分(t=10.50,P<0.05)、日常生活能力评分(t=13.22,P<0.05)均较其治疗前改善明显。患者平均住院时间为45 d。79例重型颅脑损伤患者中,49例治愈(62.03%),21例好转(26.58%),9例(11.39%)病情稳定,临床治疗总有效率为88.61%(70/79)。围术期总并发症发生率为11.39%(9/79)。随访3个月无死亡病例。 结论 对重型颅脑损伤患者围术期实施专业化护理尤其是心理护理和特别护理有助于患者获得更好的治疗效果。Abstract: Objective To summarize the main nursing measures for patients with severe craniocerebral injury during perioperative period and explore its clinical effect,thus exploring the nursing experience for clinical reference. Methods The clinical data of 79 patients with severe craniocerebral injury in our hospital from June,2015 to June,2016 were analyzed retrospectively.All the patients were treated by the operation of intracranial hematoma,and the specialized nursing staff in perioperative period.Nursing interventions for patients included psychological nursing before and after operation,special nursing care (symptomatic nursing,prevention of complications,emergency nursing) and postoperative rehabilitation training.We aim to investigate the clinical treatment and nursing intervention in patients with total effective rate,KPS score,daily life ability score,the incidence of complications. Results Before treatment the KPS score was (62.3±5.1) points,and the daily life ability score was (52.3±6.0) points;after treatment,the KPS score was (86.8±6.9) points,the daily life ability score was (52.3±6.0) points.After operation,the KPS score (t=10.50,P<0.05) and daily life ability score (t=13.22,P<0.05) of the patients were all significantly improved compared with those before treatment.he average hospital stay was 45 days.Among 79 patients with severe craniocerebral injury,49 cases were cured (62.03%),21 cases were improved (26.58%),9 cases (11.39%) were stable,and the total effective rate was 88.61%(70/79).The incidence of perioperative complications was 11.39%(9/79). Conclusion For severe brain injury patients,the clinical needs to attach importance to the implementation of professional care of the perioperative period,especially psychological care and special care,which will help patients to get better treatment effect.
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Key words:
- Severe brain injury /
- Perioperative nursing /
- Clinical effect
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