集束化护理对重型颅脑外伤患儿颅内压及预后的影响

doi:10.3969/j.issn.1008-9691.2018.04.012

科研成果详情

题名	集束化护理对重型颅脑外伤患儿颅内压及预后的影响
其他题名	Application of cluster nursing on intracranial pressure and prognosis in children with severe traumatic brain injury
作者	徐微1; 李仁芳2; 陈苗苗 1
发表日期	2018
发表期刊	中国中西医结合急救杂志影响因子和分区
语种	中文
原始文献类型	期刊论文
关键词	集束化护理颅脑外伤颅内压预后
摘要	目的探讨集束化护理对重型颅脑外伤患儿颅内压及预后的影响。方法选择温州医科大学附属第二医院儿童2016年4月至2018年1月收治的110例重型颅脑外伤患儿,按护理方法的不同分为两组,每组55例。常规组按标准方案实施常规护理;集束组在常规护理基础上由5人护理小组实施集束化护理方案 (包括心理护理、认知干预、营养支持、康复护理、皮肤护理、对症护理等)。比较两组患儿神经功能、日常生活活动能力(ADL)、运动功能、颅内压、护理满意度、预后及并发症发生情况。结果两组护理后美国国立卫生研究院卒中量表(NIHSS)、ADL评分和颅内压较治疗前明显降低,运动功能评分(Fugl-Meyer)较治疗前明显升高,且集束化方案护理组的变化较标准的常规护理对照组更显著〔NIHSS评分(分):16.14±3.45比20.12±4.23,ADL评分(分):17.16±4.03比22.06±4.92,Fugl-Meyer(分):72.56±5.13比63.47±4.06,颅内压(mmHg,1 mmHg=0.133 kPa): 16.89± 1.41比18.12± 1.69,均P<0.05〕。与常规组比较,集束组护理满意度〔94.55%(52/55)比81.82%(45/55)〕、人员满意度〔98.18%(54/55)比83.64%(47/55)〕、预后良好率〔92.73%(51/55)比74.55%(41/55)〕均明显增加,并发症发生率〔14.55%(8/55)比30.91%(17/55)〕明显减少(均P<0.05)。结论集束化护理可有效改善重型颅脑外伤患儿神经功能、ADL和运动功能,提高满意度和预后,降低颅内压和并发症发生率。
其他摘要	Objective To explore the effect of using cluster nursing on intracranial pressure and prognosis in children with severe traumatic brain injury. Methods One hundred and ten children with severe traumatic brain injury admitted to Department of Children Intensive Care Unit of the Second Hospital Affiliated to Wenzhou Medical University were enrolled, and they were divided into two groups according to different nursing methods, 55 patients in each group. The conventional group was given routine nursing care according to the standard scheme, and based on the routine nursing care, the cluster nursing care was additionally applied by 5-person nursing group in the cluster group (including psychological nursing, cognitive intervention, nutritional support, rehabilitation nursing, skin care, symptomatic nursing, etc.). The nerve functions, the ability of daily life activities, movement function, intracranial pressure, the degree of satisfaction with nursing care, incidence of complications and prognosis were compared between the children in two groups. Results After nursing care in the two groups, the score of American national institutes of health stroke scale (NIHSS), activity of daily living (ADL) scale and intracranial pressure (ICP) were significantly decreased compared with those before nursing care, while the movement function score (SFS) was significantly increased than that before nursing care, and the degrees of improvement in the cluster group were obviously more significant than those in the conventional control group [NIHSS score: 16.14 ±3.45 vs. 20.12 ±4.23, ADL score: 17.16 ±4.03 vs. 22.06±4.92,Fugl-Meyer score: 72.56±5.13 vs. 63.47±4.06, ICP (mmHg, 1 mmHg = 0.133 kPa): 16.89±1.41 vs.18.12± 1.69, all P < 0.05]. Compared with conventional group, the degree of satisfaction toward nursing care [94.55% (52/55) vs. 81.82% (45/55)], the degree of satisfaction toward employee [98.18% (54/55) vs. 83.64% (47/55)], the rate of good prognosis [92.73% (51/55) vs. 74.55% (41/55)] in the cluster group were significantly higher, while the incidence of complications was significantly lower in the intervention group [14.55% (8/55) vs. 30.91% (17/55), all P < 0.05]. Conclusion The cluster nursing measures can effectively improve the nerve functions, ADL, the movement functions, decrease intracranial pressure and the incidence of complications, enhance the degrees of satisfaction with nursing care and employee and the percentage of patients with better prognosis for children with severe traumatic brain injury.
资助项目	浙江省温州市公益性科技计划项目
ISSN	1008-9691
卷号	25 期号:4 页码:383-387
DOI	10.3969/j.issn.1008-9691.2018.04.012
页数	5
收录类别	CSCD ; 万方 ; 维普 ; PKU ; 北大核心 ; ISTIC
学科领域	医药、卫生
URL	查看原文
CSCD记录号	CSCD:6325285
引用统计
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/99198
专题	附属第二医院_儿童ICU 附属第二医院_脑外
作者单位	1.温州医科大学附属第二医院儿童ICU, 浙江, 温州, 325000 ; 2.温州医科大学附属第二医院脑外科, 浙江, 温州, 325000
第一作者单位	附属第二医院_儿童ICU
第一作者的第一单位	附属第二医院_儿童ICU
推荐引用方式 GB/T 7714	徐微,李仁芳,陈苗苗. 集束化护理对重型颅脑外伤患儿颅内压及预后的影响[J]. 中国中西医结合急救杂志,2018,25(4):383-387.
APA	徐微, 李仁芳, & 陈苗苗. (2018). 集束化护理对重型颅脑外伤患儿颅内压及预后的影响. 中国中西医结合急救杂志, 25(4), 383-387.
MLA	徐微,et al."集束化护理对重型颅脑外伤患儿颅内压及预后的影响".中国中西医结合急救杂志 25.4(2018):383-387.