Objective To investigate the efficacy of clinical nursing path in the care of severe traumatic brain injury in ICU and its effect on the recovery of neurologic function.Methods In accordance with different nursing methods,70 severe traumatic brain injury ICU patients were divided into the control group (n =33)and the observation group (n =37).The patients in the control group were given routine nursing care,while those in the observation group had special clinical nursing path.Then,Scores of Nursing Glasgow Coma Scale (GCS),Neurological Impairment Score (NIHSS),Fugl-Meyer,levels of inflammatory cytokines before and after care,SF-36 quality of life scores and incidence of complications after treatment were compared between the 2 groups both before and after nursing care.Results (1)The NIHSS scores of the two groups after nursing were significantly lower than those before nursing,and the GCS and Fugl-Meyer scores after nursing were all significantly higher than those before nursing,and statistical significance could be noted in the above scores,when comparisons were made between the two groups (P <0.05).(2)The levels of serum IL-8,IL-6,TNF-αand ICAM-1 after nursing were significantly lower than those before nursing,and the level of serum IL-10 after nursing was significantly higher than that before nursing,also with statistical significance (P <0.05).(3)Based on SF-36 scores,the scores of all the scale dimensions (emotional scores,general feeling indexes,health indexes and life satisfaction indexes)after nursing were all significantly higher than those before nursing (P <0.05),Furthermore,the above scores of the observation group after nursing were all significantly higher than those of the control group after nursing (P <0.05).(4)Incidence of complications (pressure sores,wound infection,pul-monary infection and skin rash)for the observation group were all significantly lower than that of the control group (P <0.05 ).Conclusion Clinical nursing path in the care of severe traumatic brain injury ICU patients displayed significant effects,promoted neu-rologic function and prognosis of the patients.For this reason,it was worth further application and extension clinically.%目的：探讨临床护理路径在重症颅脑损伤护理中的应用效果及其对患者神经功能恢复的作用。方法将70例重症颅脑损伤患者按照护理方法分为对照组（33例）与观察组（37例），分别采用常规措施急救与临床护理路径急救。比较2组护理前后格拉斯哥昏迷评分（GCS 评分）、神经功能缺损程度评分（NIHSS 评分）、Fugl-Meyer 运动功能评分、护理前后相关炎性因子水平、SF-36生活质量评分及护理后并发症发生率。结果2组护理后 NIHSS 评分均低于护理前，护理后 GCS 及Fugl-Meyer 评分均高于护理前，差异均具有统计学意义（P ＜0．05）；2组护理后血清 IL-8、IL-6、TNF-α及 ICAM-1水平均低于护理前，血清 IL-10水平高于护理前，差异均有统计学意义（P ＜0．05）；根据 SF-36量表评分，2组护理干预后量表各维度（情感得分、一般感情指数、健康指数及生活满意度）评分均高于护理干预前（P ＜0．05），观察组护理干预后上述评分均高于对照组护理干预后（P ＜0．05）；观察组护理后并发症（压疮、切口感染、肺部感染及皮疹）发生率均低于对照组（P ＜0．05）。结论临床护理路径在重症颅脑损伤护理中的应用效果显著，可促进患者神经功能恢复及改善患者预后状况，可以在临床上进行推广、应用。
展开▼
