定向力评定在神经外科重症监护病房患者解除身体约束中的应用

发布时间：2018-01-29 00:03

本文关键词： 定向力认知约束身体的　出处：《中华护理杂志》2017年11期 　论文类型：期刊论文

【摘要】：目的探索适用于神经外科重症监护病房(neurosurgical intensive care unit,NICU)患者解除身体约束的评估工具。方法对70例格拉斯哥昏迷评分(Glasgow Coma Scale,GCS)13~15分且实施身体约束的NICU患者,使用改良版约翰霍普金斯认知量表(Adapted Johns-Hopkins Cognitive Exam,ACE)进行评定。根据评定结果分为定向力正常组和定向力非正常组,对定向力正常组解除身体约束,观察两组非计划拔管发生情况及整体认知功能情况。结果定向力正常组解除身体约束后无非计划拔管发生,定向力非正常组有5例发生6次拔管(P0.05)。就整体认知功能状况而言,定向力正常组测得其他认知分项及总分分值均明显高于定向力非正常组(P0.05)。结论 ACE可作为NICU患者定向力评估的工具,定向力正常可作为判断GCS评分13~15分的NICU患者解除身体约束的一个指征。
[Abstract]:Objective to explore the application of neurosurgical intensive care unit in neurosurgical intensive care unit (ICU). Methods 70 cases of Glasgow Coma Scale were assessed with Glasgow Coma Scale. NICU patients with 13 ~ 15 GCS and physical restraint. The modified Johns Hopkins Cognitive scale was used to adapt Johns-Hopkins Cognitive Exam. According to the results of the evaluation, it was divided into normal directional force group and non-normal orientation force group. Results the unplanned extubation and the overall cognitive function were observed in the two groups. In the group of abnormal directional force, 6 extubation occurred in 5 cases (P0.05A). As far as the overall cognitive function was concerned. The scores of other cognitive sub-items and total scores were significantly higher in the group with normal orientation than those in the group with abnormal orientation (P 0.05). Conclusion ACE can be used as a tool for the evaluation of orientation in patients with NICU. The normal orientation can be used as an indication of the release of physical restraint in patients with NICU with GCS scores of 13 ~ 15 points.
【作者单位】：常州市第一人民医院神经外科;常州市第一人民医院康复医学科;
【基金】：常州市卫生与计划生育委员会指导性科技项目(WZ201611)
【分类号】：R473.6
【正文快照】： 研究[1-3]发现,神经外科最易发生非计划拔管不良事件,拔管患者中以格拉斯哥昏迷评分(Glas-gow Coma Scale,GCS)13~15分居多。鉴于此,神经外科重症监护病房(neurosurgical intensive care unit,NICU)护士多使用身体约束以防止患者非计划拔管[4],然而约束的解除却是一延再延。究

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