急性颅脑损伤致早期精神障碍的危险因素及护理预防对策

摘要

目的 探讨急性颅脑损伤致早期精神障碍的危险因素,为制定护理预防对策提供依据.方法 回顾性分析2015年1月至12月我院收治174例急性颅脑损伤患者临床资料,分析颅脑损伤致精神障碍危险因素.并对2016年1月至12月我院152例急性颅脑损伤患者,针对颅脑损伤后精神障碍危险因素,实施护理预防对策.结果 174例急性颅脑损伤患者,精神障碍发生率为60.9%.多元Logistic回归分析显示,性别、年龄、入院时格拉斯哥昏迷指数(GCS)评分、艾森克人格问卷(EPQ)评分、血清白细胞介素(IL)-1β、额叶损伤、颅内感染、颅内血肿、低氧血症、单人病房、护理质量、预防性使用抗精神病药物均为颅脑损伤致早期精神障碍的危险因素(P<0.05);实施护理预防对策后,颅脑损伤后精神障碍发生率为40.1%,较实施前(60.9%)明显降低,差异有统计学意义(x2=14.032,P<0.05).结论 颅脑损伤致精神障碍发生率较高,且影响因素众多,针对高危因素制定预防护理对策有助于减少精神障碍发生.%Objective To explore the risk factors of early mental disorders caused by acute craniocerebral injury ,and to provide basis for the development of nursing preventive measures .Methods The clinical data of 174 patients with acute craniocerebral injury treated in the hospital from January to December 2015 were analyzed retrospectively ,and the risk factors of mental disorders caused by craniocerebral injury were analyzed .Another 152 patients with acute craniocerebral injury treated in the hospital from January to December 2016 were selected and were given nursing according to the risk factors of early mental disorders caused by craniocerebral injury .Re-sults The incidence of mental disorders in the 174 patients with acute craniocerebral injury was 60.9% .Multiva-riate Logistic regression analysis showed that gender ,age ,the Glasgow coma score (GCS) on admission ,the Ey-senck Personality Questionnaire (EPQ) score ,serum IL-1β,frontal lobe injury ,intracranial infection ,intracranial hematoma ,hypoxemia ,single ward ,nursing quality and prophylactic use of antipsychotic drugs were risk factors of early mental disorders caused by craniocerebral injury (P<0.05) .After the implementation of nursing preven-tive measures ,the incidence of mental disorders after craniocerebral injury was 40.1% ,which was significantly lower than that before the implementation (60.9% ) (x2 =14.032 ,P<0.05) .Conclusion The incidence of men-tal disorders caused by craniocerebral injury is high ,and there are many influencing factors .It is helpful to prevent mental disorders by formulating preventive nursing measures according to the high risk factors .