摘要
目的:探讨护理干预措施对ICU血肿清除术后昏迷患者作用及脑电双频指数(BIS)监测对其指导意义。方法:行开颅手术后仍昏迷而送ICU监护患者80例,随机分为对照组和观察组,各40例。2组患者术后均给予对症治疗并进行24 h BIS监测,对照组患者给予常规护理,观察组患者进行加强呼吸道、导管管理等护理干预措施。比较2组患者预后情况,不同预后患者BIS值和呼吸机使用时间,分析BIS值与格拉斯哥昏迷评分和反应水平分级的相关性。结果:所有患者经半年随访,观察组预后良好例数明显多于对照组(P<0.01)。观察组中,预后良好患者的BIS值明显高于预后不良者,呼吸机使用时间显著少于预后不良者(P<0.01)。相关分析显示,BIS值与格拉斯哥昏迷评分呈正相关关系,BIS值与反应水平分级呈负相关关系(P<0.05)。结论:有效的护理干预能明显提高预后效果,降低病死率,BIS监测可有效反映患者脑功能障碍程度和预后情况。
Objective： To explore the effects of the nursing intervention and guiding significance of bispectral index BIS monitoring in coma patients after hematoma clearance. Methods： Eighty coma patients after craniotomy operation in ICU were randomly divided into the control group and observation group（ 40 cases each group）. Two groups were treated with symptomatic therapy and 24 h reaction level scale（ BIS） monitoring. The control group were nursed with the route method,and the observation group were nursed with strengthening the respiratory tract and catheter management. The prognosis condition,BIS value and respirator use time in different prognosis patients between two groups were compared. The correlation of BIS value with GCS score and RLS classification were analyzed. Results： All patients were followed up for half a year,the number of cases with good prognosis in observation group were significantly higher than that in control group（ P〈0. 01）. Among the observation group,the BIS value and respirator use time in patients with good prognosis were significantly higher and less than those in patient with poor prognosis,respectively（ P〈0. 01）. The correlation analysis showed that the BIS value was positive correlation with GCS score,and negative correlation with RLS classification（ P〈0. 05）. Conclusions： The effective nursing intervention can significantly improve the prognosis,and reduce the mortality. The BIS monitoring can effectively reflect the degree of cerebral dysfunction and prognosis of patients.
作者
林凡菊
陈莉芳
LIN Fan-ju CHEN Li-fang(Department of ICU, Shuguang Hospital Affiliated to Shanghai Traditional Chinese Medicine University, Shanghai 201210, China)
出处
《蚌埠医学院学报》
CAS
2016年第8期1089-1091,共3页
Journal of Bengbu Medical College
关键词
昏迷
血肿清除术
脑电双频指数
干预
coma
hematoma clearance
bispectral index
nursing intervention
