預見性護理在ICU重癥顱腦損傷合并糖尿病患者預防壓力性損傷中的應用

陳晗

[摘要] 目的 探討預見性護理在ICU重癥顱腦損傷合并糖尿病患者壓力性損傷預防中的應用效果。方法 從2018年3月—2019年12月階段在該院ICU住院治療的重癥顱腦損傷合并糖尿病患者中選取84例，根據護理方法分為觀察組和對照組，每組42例。在ICU治療期間，對照組給予常規壓力性損傷護理，觀察組則給予壓力性損傷預見性護理。結果 兩組患者護理前的各項Braden評分差異無統計學意義（P>0.05）;經護理干預后，觀察組患者的各項Braden評分，均顯著高于對照組（P<0.05）。觀察組患者的壓力性損傷發生率0.00%，顯著低于對照組4.76%（P<0.05）。觀察組患者的空腹血糖水平顯著低于對照組（P<0.05）。結論 預見性護理能夠有效規避ICU重癥顱腦損傷合并糖尿病患者的壓力性損傷高危因素，從而顯著降低壓力性損傷發生率，且利于促進患者的血糖控制。

[關鍵詞] 預見性護理;ICU;重癥顱腦損傷;糖尿病;壓力性損傷;預防

[中圖分類號] R47 ? ? ? ? ?[文獻標識碼] A ? ? ? ? ?[文章編號] 1672-4062（2020）11（a）-0145-03

[Abstract] Objective To explore the effect of predictive nursing in the prevention of severe head injury combined with diabetes mellitus in ICU. Methods From March 2018 to December 2019， 84 patients with severe brain injury and diabetes were selected from ICU of the hospital. According to the nursing methods， they were divided into observation group and control group， 42 cases in each group. During the treatment in ICU， the control group was given routine nursing care of stress injury， while the observation group was given predictive nursing care of stress injury. Results There was no statistically significant difference in Braden scores between the two groups of patients before nursing （P>0.05）; after nursing intervention， the scores of Braden in the observation group were significantly higher than those in the control group（P<0.05）. The incidence of pressure injury in the observation group was 0.00%， significantly lower than that in the control group 4.76%（P<0.05）. The fasting blood glucose level in the observation group was significantly lower than that in the control group（P<0.05）. Conclusion Predictive nursing can effectively avoid the high risk factors of stress injury in ICU patients with severe craniocerebral injury and diabetes， so as to significantly reduce the incidence of stress injury， and promote the blood glucose control of patients.

[Key words] Predictive nursing; ICU; Severe craniocerebral injury; Diabetes mellitus; Stress injury; Prevention

重癥顱腦損傷屬于臨床上的一種危急重癥，嚴重危害患者的生命健康。隨著糖尿病發病率的升高，使得臨床接診的重癥顱腦損傷合并糖尿病患者明顯增多，這給臨床治療和護理均帶來較大的難度[1]。對于重癥顱腦損傷合并糖尿病患者來說，由于患者病情較重，需絕對臥床，加之受到糖尿病的影響，導致這類患者成為了ICU壓力性損傷的高發人群[2]。而對于重癥顱腦損傷合并糖尿病患者來說，一旦發生壓力性損傷，則會患者帶來較大的痛苦，同時還會影響患者的治療效果，危害甚大[3]。因此，積極地采取有效的手段來預防重癥顱腦損傷合并糖尿病患者發生壓力性損傷，是非常重要的[4]。該研究以2018年3月—2019年12月在該院ICU住院治療的84例重癥顱腦損傷合并糖尿病患者為例，對預見性護理在ICU重癥顱腦損傷合并糖尿病患者壓力性損傷預防中的應用效果進行了分析，現報道如下。

1 ?資料與方法

1.1 ?一般資料