早期感觉促醒干预对急性缺血性脑卒中昏迷的效果The Effect of Early Wake-promoting Nursing Care for Coma Patients with Acute Ischemic Stroke
曾雯,郭永洪,伍国锋,安啟萍,王莉,李娟
ZENG Wen,GUO Yonghong,WU Guofeng,AN Qiping,WANG Li,LI Juan
摘要(Abstract):
目的:评价早期感觉促醒对急性缺血性脑卒中(AIS)昏迷患者的临床效果。方法:83例AIS昏迷患者随机分成实验组(n=42)和对照组(n=41),对照组采用常规护理,实验组在常规护理的基础上给予早期促醒护理措施;干预2周后,分别采用美国国立卫生研究院卒中量表(NIHSS)评分及Glasgow昏迷评定量表(GCS)评分评价两组患者意识改善情况、神经功能改善情况,比较两组患者入住神经科重症监护室(NICU)时长。结果:干预前2组患者NIHSS评分及GCS评分差异均无统计学意义(P> 0. 05),干预后两组患者NIHSS评分及GCS评分均有所改善,且实验组干预后NIHSS评分及GCS评分明显优于对照组(P <0. 05);实验组入住NICU时长短于对照组,差异均具有统计学意义(P <0. 05)。结论:早期感觉促醒干预能够有效改善AIS昏迷患者的意识状态和神经功能,缩短患者的住院时长。
Objective: To evaluate the effectiveness of early wake-promoting nursing care for coma patients with acute ischemic stroke(AIS). Methods: 83 coma patients with AIS were involved in the current study. The subjects were randomly divided into the experimental group and the control group.Conventional nursing care was offered to the patients in the controls. Early wake-promoting nursing care in addition to the conventional care was provided for patients in the experimental group. Two weeks later,the difference of consciousness scale,neurological deficit scale and length of stay in the NICU of the two groups was evaluated by NIHSS and GCS. Results: There was a significant difference in the consciousness scale,neurological deficit scale and length of stay in the NICU between the two groups(P < 0. 05). Conclusion: Early wake-promoting nursing care can improve the consciousness of coma patients with AIS and shorten the length of stay in the NICU. Therefore,it is worth applying early wake-promoting nursing care in the clinical treatment of AIS.
关键词(KeyWords):
卒中;缺血缺氧,脑;昏迷;促醒;意识;神经功能
stroke;ischemia and hypoxia,brain;coma;arousal;consciousness;neurologic function
基金项目(Foundation): 贵州省高血压脑出血微创诊疗科技创新人才团队基金[黔科合人才团队(2014)240]
作者(Author):
曾雯,郭永洪,伍国锋,安啟萍,王莉,李娟
ZENG Wen,GUO Yonghong,WU Guofeng,AN Qiping,WANG Li,LI Juan
DOI: 10.19367/j.cnki.1000-2707.2018.11.026
参考文献(References):
- [1]SACCO R L,KASNER S E,BRODERICK J P,et al. An updated definition of stroke for the 21st century:a statement for healthcare professionals from the American Heart Association/American Stroke Association[J]. Stroke,2013,44(7):2064-2089.
- [2]SAKA,MCGUIRE A,WOLFE C. Cost of stroke in the United Kingdom[J]. Age Ageing,2009,38(1):27-32.
- [3]MISHRA A K,MISHRA N,GAJJAR K. Financial burden of stroke on family and caregiver in India:a literature review[J]. Int J Res Med Sci,2016,4(10):3675-3678.
- [4]LI S,ZANINOTTO A L,NEVLIIE I S,et al. Clinical utility of brain stimulation modalities following traumatic brain injury:current evidence[J]. Neuropsychiatr Dis Treat,2015,30(11):1573-1586.
- [5]中华神经科学会,中华神经外科学会.各类脑血管疾病诊断要点(1995)[J].中华神经科杂志,1996,29(6):379.
- [6] TEASDALE G,JENNETT B. Assessment of coma and impaired consciousness:a practical scale[J]. Lancet,1974,304(7872):81-84.
- [7] KWAH L K,DIONG J. National institutes of health stroke scale(NIHSS)[J]. J Physiother,2014,60(1):61-63.
- [8]SUN J,CHEN W. Music therapy for coma patients:preliminary results[J]. Eur Rev Med Pharmacol Sci,2015,19(7):1209-1218.
- [9]ABBATE C,TRIMARCHI P D,BASILE I,et al. Sensory stimulation for patients with disorders of consciousness:from stimulation to rehabilitation[J]. Front Hum Neurosci,2014,11(8):616.
- [10]KARMA D,RAWAT A. Effect of stimulation in coma[J]. Indian Pediatr,2006,43(10):856-860.
- [11]刘春燕.刺激性护理干预在急性脑卒中昏迷患者促醒中的效果[J].河南医学研究,2017,26(12):2304.
- [12]刘向力,陈雪梅,温春娣,等.刺激性护理干预在急性脑卒中昏迷患者促醒中的应用[J].岭南现代临床外科,2014,14(5):615-616.
- [13]REJDAK K,PETZOLD A,LIN L,et al. Decreased CSF hypocretin-1(orexin-A)after acute haemorrhagic brain injury[J]. J Neurol Neurosurg Psychiatry,2005,76(4):597-598.
- [14]FENG Z,ZHONG Y J,WANG L,et al. Resuscitation therapy for traumatic brain injury-induced coma in rats:mechanisms of median nerve electrical stimulation[J].Neural Regen Res,2015,10(4):594-598.
- [15]GAO X B,WANG A H. Experience-dependent plasticity in hypocretin/orexin neurones:re-setting arousal threshold[J]. Acta Physiologica,2010,198(3):251-262.
- [16]SAKURAI T,MIEDA M. Connectomics of orexin-producing neurons:interface of systems of emotion,energy homeostasis and arousal[J]. Trends Pharmacol Sci,2011,32(8):451-462.
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