摘要
目的 观察脑温变化对高血压性脑出血 (HIH)患者预后的影响 ,探讨HIH高热患者的护理对策。方法 93例患者 ,碎吸术后均用点式温度计进行脑温直接监测 ,点式温度计的放置时间为 4～ 5d ,记录时间为 2h/次。 93例患者 ,分为 3组 ,A组 32例 ,将患者头部置于颅脑降温治疗仪 (HTI)头盔内密闭 ,头盔内温度控制在 0± 2℃。B组31例 ,将患者头部两侧及顶部放置数个冰袋。C组 30例 ,采用其他物理降温等护理方法。 3组药物降温方法相同。以 3组患者出院为统计界限、以 3组脑温 ,治疗前后神经功能缺损评分 (NDS)及日常生活能力评定 (ADL)为观察指标。结果 3组比较A组脑温明显降低 (P <0 .0 5 ) ,B组较C组脑温显著降低 (P <0 .0 5 )。NDS 3组比较 ,A组较B、C两组降低更显著 (P <0 .0 1 ) ;B组较C组明显降低 (P <0 .0 5 )。 3组ADL比较 ,A组较B、C两组降低更明显 (P <0 .0 1 ) ;B组较C组显著降低 (P <0 .0 5 )。结论 脑温变化高低直接影响HIH患者预后 ,HIH患者头部降温应首选HTI。
Objective To observe the effect of brain temperature change on prognosis of hypertensive intracerebral hemorrhage (HIH), and discuss nursing strategy for hyperthermic HIH patients.Methods 93 patients were divided into three groups: group A (n=32), who used the head temperature control instrument (HTI) with the inside temperature controlled at 0±2℃; group B (n=31), who used ice bags around their heads; and group C (n=30), who used other physical methods of lowering temperature.(All patients brain temperature was straight measured by point style temperature after broken suction operation).Temperature was measured for 4～5 d at an interval of 2 h.The antipyretics for the three groups were the same. The statistic limit was set at the time of discharge. The observation indexes included brain temperature, neurological deficiency score (NDS) before and after treatment, activity daily living (ADL).Results Brain temperature of group A group dropped more significantly than that of groups B and C (P<0.05), and brain temperature of group B dropped more significantly than that of group C (P<0.05) . NDS and ADL of group A were significantly lower than those of group B and C (P<0.01), and NDS and ADL of group B were significantly lower than those of group C(P<0.05) .Conclusion Change in brain temperature straightly affects the prognosis of HIH patients . HTI should be the technique of choice in lowering brain temperature.
出处
《解放军护理杂志》
2003年第6期21-22,共2页
Nursing Journal of Chinese People's Liberation Army
