循证护理干预对ICU重症颅脑外伤患者的临床应用

摘要

目的:研究循证护理干预在重症医学科(ICU)重症颅脑外伤患者中的应用效果.方法:选取2015年9月至2016年12月期间我院ICU进行治疗的102例重症颅脑外伤患者,按照乱数表法平均分为观察组与对照组两组.观察组患者给予循证护理干预,对照组患者采用常规护理措施,记录并分析两组的包括机械通气、ICU治疗和住院时间在内的3项临床护理时间指标,接受护理前后的神经功能(NIHSS)评分和运动功能(FMA)评分的改善情况,以及院内感染发生率.所得数据采用统计学软件SPSS 19.0分析处理.结果:观察组患者的3项临床护理时间与对照组相比均明显缩短,且差异有统计学意义(P＜0.05).与护理前比较,两组患者经过相应护理措施干预后,NIHSS评分与FMA评分均显著改善,差异均具统计学意义(P＜0.05);护理后组间差异,观察组的NIHSS评分与FMA评分显著优于对照组,差异均具统计学意义(P＜0.05).观察组的褥疮、感染发生率(切口感染、胃肠道感染、肺部感染、泌尿道感染)与对照组相比,均差异显著(P＜0.05).结论:对ICU重症颅脑外伤患者进行循证护理干预,对于临床治疗时间的缩短,患者神经功能与运动功能的改善有显著效果,并能有效预防院内感染.%Objective:To study the application effect of evidence-based nursing intervention in ICU patients with severe traumatic brain injury.Methods:102 patients with severe traumatic brain injury treated in our hospital from September 2015 to December 2016 were selected as the subjects.According to the random number table method,they were divided into the control group and the observation group,each with 49 case.The control group were treated with routine nursing care,while the observation group received evidence-based nursing intervention.The clinical treatment time (mechanical ventilation,ICU treatment and hospitalization time),neurological function (NIHSS score) and motor function(FMA score) before and after treatment and the incidence of hospital infection were recorded and compared in two groups.The data were analyzed by statistical software SPSS 19.0.Results:The mechanical ventilation time,ICU treatment time and hospitalization time of the observation group were significantly shorter than those of the control group,and the difference was statistically significant(P ＜ 0.05).After the treatment,NIHSS score and FMA score were significantly improved in two groups,and the differences were statistically significant (P ＜ 0.05);after the nursing,NIHSS score and FMA score of the observation group were better than the control group,and the difference was statistically significant(P ＜ 0.05).The incidence rate of pressure ulcers,incision infection,gastrointestinal infection,pulmonary infection and urinary tract infection in the observation group were significantly lower than those in the control group,and the difference was statistically significant (P ＜ 0.05).Conclusion:Evidence-based nursing intervention on ICU patients with severe traumatic brain injury can significantly shorten the treatment time,and improve their neurological function and motor function,and it has a positive preventive effect on hospital infection.Therefore,it is worthy of further optimization and popularization in clinic practice.