早期康复护理干预对创伤性颅脑损伤病人神经功能、认知功能及生活质量的影响
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摘要
目的:分析早期康复护理干预对创伤性颅脑损伤病人神经功能、认知功能及生活质量的影响。方法:将68例创伤性颅脑损伤病人作为研究对象,随机分为对照组和强化组,对照组给予常规护理干预,强化组在对照组护理基础上给予早期康复护理干预。比较2组美国国立卫生研究院卒中量表(NIHSS)、简易智力状态检查量表(MMSE)及生活质量评分(QOL)情况。结果:护理后,2组NIHSS评分较护理前均降低(P <0. 01),且强化组较对照组显著降低(P <0. 01); MMSE评分较护理前均升高(P <0. 01),且强化组较对照组显著升高(P <0. 01);护理后强化组物质功能、日常生活功能、社会功能及心理功能等QOL各项指标评分及总分较对照组均明显升高(P <0. 01)。结论:早期康复护理干预能够明显改善创伤性颅脑损伤病人神经功能、认知功能,有助于促进病人脑功能的恢复,且能够明显提高病人的生活质量,具有良好的临床应用价值。
Objective: To analyze the effects of early rehabilitation nursing intervention on neurological function,cognitive function and quality of life in patients with traumatic brain injury. Methods: Sixty-eight patients with traumatic brain injury were randomly divided into the control group( nursing with routine intervention) and intensive group( nursing with early rehabilitation intervention on the basis of the control group)( 34 cases each group). The scores of National Institute of Health Stroke Scale( NIHSS),Mini-mental State Examination( MMSE) and Quality of Life Scale( QOL) were compared between two groups. Results: The NIHSS scores in two groups after nursing significantly decreased compared with before nursing( P < 0. 01),and the decreasing degree of which in intensive group was significantly larger than that in control group( P < 0. 01). The MMSE scores in two groups after nursing significantly increased compared with before nursing( P < 0. 01),and the increasing degree of which in intensive group was significantly larger than that in control group( P < 0. 01). The score of each indicator of QOL( including physical function,daily life,social function and psychological function) and its total score in intensive group after nursing were significantly higher than those in control group( P < 0. 01).Conclusions: Early rehabilitation nursing intervention can significantly improve the neurological function and cognitive function of patients with traumatic brain injury,which can help to promote the recovery of brain function,significantly improve the quality of life,and has good clinical application value.
Objective: To analyze the effects of early rehabilitation nursing intervention on neurological function,cognitive function and quality of life in patients with traumatic brain injury. Methods: Sixty-eight patients with traumatic brain injury were randomly divided into the control group( nursing with routine intervention) and intensive group( nursing with early rehabilitation intervention on the basis of the control group)( 34 cases each group). The scores of National Institute of Health Stroke Scale( NIHSS),Mini-mental State Examination( MMSE) and Quality of Life Scale( QOL) were compared between two groups. Results: The NIHSS scores in two groups after nursing significantly decreased compared with before nursing( P < 0. 01),and the decreasing degree of which in intensive group was significantly larger than that in control group( P < 0. 01). The MMSE scores in two groups after nursing significantly increased compared with before nursing( P < 0. 01),and the increasing degree of which in intensive group was significantly larger than that in control group( P < 0. 01). The score of each indicator of QOL( including physical function,daily life,social function and psychological function) and its total score in intensive group after nursing were significantly higher than those in control group( P < 0. 01).Conclusions: Early rehabilitation nursing intervention can significantly improve the neurological function and cognitive function of patients with traumatic brain injury,which can help to promote the recovery of brain function,significantly improve the quality of life,and has good clinical application value.
引文
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[11]SHAN R,SZMYDYNGER-CHODOBXKA J,WARREN OU,et al. A new panel of blood biomarkers for the diagnosis of mild traumatic brain injury/concussion in adults[J]. J Neurotr,2016,33(1):49.
[12]张玉芳,赖素勇.中重型颅脑损伤继发脑梗死的危险因素分析及护理对策[J].广东医学,2013,34(4):655.
[13]AGRAWAL D,RAGHAVENDRAN K,SCHAUBEL DE,et al. A propensity score analysis of the impact of invasive intracranial pressure monitoring on outcomes after severe traumatic brain injury[J]. J Neurotr,2016,33(9):853.
[14]赵德芹,张永秀.早期康复护理干预对创伤性颅脑损伤病人的影响[J].齐鲁护理杂志,2016,22(8):29.
[15]刘佳翠.临床护理路径在颅脑损伤合并休克病人中的应用价值[J].实用临床医药杂志,2013,17(10):35.
[2]李晓莉,艾艳.早期康复护理干预对创伤性颅脑损伤病人的神经、肢体运动及生活质量的影响[J].实用医院临床杂志,2017,14(4):200.
[3]陈贞素,郑锦辉,方志红,等.早期康复护理干预对创伤性颅脑损伤病人肢体运动和认知功能的影响[J].中国医药导报,2014,11(5):123.
[4]ROBERTSON CS,HANNAY HJ,YAMAL JM,et al. Effect of erythropoietin and transfusion threshold on neurological recovery after traumatic brain injury:a randomized clinical trial[J].JAMA,2014,312(1):36.
[5]TISHERMAN SA,SCHMICKER RH,BRASEL KJ,et al. Detailed description of all deaths in both the shock and traumatic brain injury hypertonic saline trials of the Resuscitation Outcomes Consortium[J]. Ann Surg,2015,261(3):586.
[6]TAVENDER EJ,BOSCH M,GRUEN RL,et al. Developing a targeted,theory-informed implementation intervention using two theoretical frameworks to address health professional and organisational factors:a case study to improve the management of mild traumatic brain injury in the emergency department[J].Implement Sci,2015,10(1):74.
[7]TAVENDER EJ,BOSCH M,GRUEN RL,et al. Understanding practice:the factors that influence management of mild traumatic brain injury in the emergency department-a qualitative study using the Theoretical Domains Framework[J]. Implement Sci,2014,9(1):8.
[8]谢家兴,张小年.创伤性颅脑损伤病人神经功能障碍的康复护理[J].护理学杂志,2012,27(8):86.
[9]MURPHY MP,CARMINE H,KOLAKOWSKY-HAYNER S.Modifiable and nonmodifiable risk factors for falls after traumatic brain injury:an exploratory investigation with implications for medication use[J]. Rehabil Nurs,2014,39(3):113.
[10]余燕梅,曹玉芳. ICU颅脑损伤病人早期营养支持的临床护理干预[J].实用临床医药杂志,2017,21(16):11.
[11]SHAN R,SZMYDYNGER-CHODOBXKA J,WARREN OU,et al. A new panel of blood biomarkers for the diagnosis of mild traumatic brain injury/concussion in adults[J]. J Neurotr,2016,33(1):49.
[12]张玉芳,赖素勇.中重型颅脑损伤继发脑梗死的危险因素分析及护理对策[J].广东医学,2013,34(4):655.
[13]AGRAWAL D,RAGHAVENDRAN K,SCHAUBEL DE,et al. A propensity score analysis of the impact of invasive intracranial pressure monitoring on outcomes after severe traumatic brain injury[J]. J Neurotr,2016,33(9):853.
[14]赵德芹,张永秀.早期康复护理干预对创伤性颅脑损伤病人的影响[J].齐鲁护理杂志,2016,22(8):29.
[15]刘佳翠.临床护理路径在颅脑损伤合并休克病人中的应用价值[J].实用临床医药杂志,2013,17(10):35.