消化道护理对重型颅脑外伤患者并发症及预后影响分析.docVIP

消化道护理对重型颅脑外伤患者并发症及预后影响分析 　　[摘要] 目的 探讨消化道护理干预对重型颅脑外伤患者并发症及预后的影响。方法 方便选取该院2014年6月―2017年6月因重型颅脑外伤进行机械通气的240例患者，随机分成对照组（n=120），观察组（n=120）。对照组进行常规护理，观察组则在常规护理的基础上加??消化道护理干预。比较两组患者的机械通气时间、ICU住院时间及总住院时间、并发症、死亡率、日常生活能力指数（BI）、Fugl-Meyer运动功能评分（FMA）的差异。结果 观察组的机械通气时间为（5.22±0.69）d、ICU住院时间及总住院时间为（9.25±3.55）d、VAP发生率为5%、消化道溃疡发生率为3.33%、其他并发症发生率为8.33%、病死率为21.67%；对照组的机械通气时间为（7.56±1.22）d、ICU住院时间及总住院时间为（11.65±4.05）d、VAP发生率为20.00%、消化道溃疡发生率为15.00%、其他并发症发生率为18.33%、病死率为33.33%；由此可知，观察组的各项指标明显低于对照组，差异有统计学意义（P0.05）。结论 对重型颅脑外伤患者在机械通气时加强消化道护理干预有助于降低VAP发病率及相关并发症，有利于改善患者预后，值得推广应用。 　　[关键词] 消化道护理；重型颅脑外伤；机械通气；并发症；预后 　　[中图分类号] R6 [文献标识码] A [文章编号] 1674-0742（2017）12（a）-0159-03 　　[Abstract] Objective To study the effect of digestive tract nursing on the complications and prognosis of patients with severe craniocerebral trauma. Methods 240 cases of severe craniocerebral trauma patients with mechanical ventilation in our hospital from June 2014 to June 2017 were convenient selected and randomly divided into two groups with 120 cases in each， the control group adopted the routine nursing， while the observation group enhanced the digestive tract nursing intervention on the basis of the routine nursing， and the mechanical ventilation time， ICU length of stay and total length of stay， complication， mortality， BI， FMA were compared between the two groups. Results The mechanical ventilation time， ICU length of stay and total length of stay， incidence rates of VAP， digestive tract ulcer， other complications， mortality， in the observation group were obviously lower than those in the control group， [（5.22±0.69）d， （9.25±3.55）d， 5%， 3.33%， 8.33%， 21.67% vs （7.56±1.22）d， （11.65±4.05）d， 20.00%，15.00%，18.33%，33.33%]， and the differences were statistically significant（P0.05）. Conclusion Enhancing the digestive tract nursing intervention in severe craniocerebral trauma patients at mechanical ventilation contributes to reducing the morbidity of VAP and related complications， which is conducive to improving the prognos