中华现代护理杂志
中華現代護理雜誌
중화현대호리잡지
CHINESE JOURNAL OF MODERN NURSING
2014年
4期
474-476
,共3页
脑损伤%甘露醇%留置时间%血管损伤
腦損傷%甘露醇%留置時間%血管損傷
뇌손상%감로순%류치시간%혈관손상
Brain trauma%Mannitol%Indwelling time%Vessel damage
目的：比较半量与全量甘露醇对中重症脑外伤患者留置针安全留置时间及血管损伤的影响。方法将154例中重症脑外伤患者按抛硬币法随机分为全量组77例，半量组77例，全量组患者给予20％甘露醇250 ml持续静脉滴注，半量组患者给予20％甘露醇125 ml静脉滴注，比较两组患者的静脉留置时间及血管损伤程度。结果全量组静脉留置时间＜4 d占37．67％，4～6 d占41．56％，7～10 d占20．77％，＞10 d占0．00％，明显优于半量组的22．08％，36．36％，38．96％，2．60％，差异有统计学意义（χ2＝5．774，P＜0．05）；患者处于昏迷/昏睡状态时，半量组静脉留置针留置时间＞10 d患者所占比例为4．25％，明显高于全量组的0．00％，差异有统计学意义（χ2＝6．720，P＜0．05）；全量组血管Ⅰ度损伤25例，Ⅱ度损伤21例，Ⅲ度损伤15例，损伤程度明显较半量组严重，差异有统计学意义（ Z＝6．469， P＜0．05）。结论对于输液时间长、处于昏迷或昏睡状态以及老年患者应采用适宜的静脉针留置时间，同时提高对皮肤血管的针对性护理，预防药物引起的血管组织损伤，促进患者康复。
目的：比較半量與全量甘露醇對中重癥腦外傷患者留置針安全留置時間及血管損傷的影響。方法將154例中重癥腦外傷患者按拋硬幣法隨機分為全量組77例，半量組77例，全量組患者給予20％甘露醇250 ml持續靜脈滴註，半量組患者給予20％甘露醇125 ml靜脈滴註，比較兩組患者的靜脈留置時間及血管損傷程度。結果全量組靜脈留置時間＜4 d佔37．67％，4～6 d佔41．56％，7～10 d佔20．77％，＞10 d佔0．00％，明顯優于半量組的22．08％，36．36％，38．96％，2．60％，差異有統計學意義（χ2＝5．774，P＜0．05）；患者處于昏迷/昏睡狀態時，半量組靜脈留置針留置時間＞10 d患者所佔比例為4．25％，明顯高于全量組的0．00％，差異有統計學意義（χ2＝6．720，P＜0．05）；全量組血管Ⅰ度損傷25例，Ⅱ度損傷21例，Ⅲ度損傷15例，損傷程度明顯較半量組嚴重，差異有統計學意義（ Z＝6．469， P＜0．05）。結論對于輸液時間長、處于昏迷或昏睡狀態以及老年患者應採用適宜的靜脈針留置時間，同時提高對皮膚血管的針對性護理，預防藥物引起的血管組織損傷，促進患者康複。
목적：비교반량여전량감로순대중중증뇌외상환자류치침안전류치시간급혈관손상적영향。방법장154례중중증뇌외상환자안포경폐법수궤분위전량조77례，반량조77례，전량조환자급여20％감로순250 ml지속정맥적주，반량조환자급여20％감로순125 ml정맥적주，비교량조환자적정맥류치시간급혈관손상정도。결과전량조정맥류치시간＜4 d점37．67％，4～6 d점41．56％，7～10 d점20．77％，＞10 d점0．00％，명현우우반량조적22．08％，36．36％，38．96％，2．60％，차이유통계학의의（χ2＝5．774，P＜0．05）；환자처우혼미/혼수상태시，반량조정맥류치침류치시간＞10 d환자소점비례위4．25％，명현고우전량조적0．00％，차이유통계학의의（χ2＝6．720，P＜0．05）；전량조혈관Ⅰ도손상25례，Ⅱ도손상21례，Ⅲ도손상15례，손상정도명현교반량조엄중，차이유통계학의의（ Z＝6．469， P＜0．05）。결론대우수액시간장、처우혼미혹혼수상태이급노년환자응채용괄의적정맥침류치시간，동시제고대피부혈관적침대성호리，예방약물인기적혈관조직손상，촉진환자강복。
Objective To compare the effect and safety of full-doses and half-doses mannitol on the indwelling time and vessel damage of the indwelling needles when treating patients with moderate or severe brain trauma.Methods One hundred and fifty-four patients with moderate or severe brain trauma treated with 20%mannitol were randomly divided into the full-dose group and the half-dose group, 77 cases each.The patients in the full-dose group were intravenously given 20% mannitol for 250 ml, and the patients in the half-dose group were intravenously given 20% mannitol for 125 ml.Compare the indwelling time and vessel damage of the injection sites between the two groups .Results In the full-dose group, the indwelling time below 4 days, between 4-6 days, between 7 -10 days and over 10 days were 37.67%, 41.56%, 20.77%, 0.00%, respectively .In the half-dose group, the indwelling time below 4 days, between 4-6 days, between 7-10 days and over 10 days were 22.08%, 36.36%, 38.96%, 2.60%, respectively.The differences between groups were significant (χ2 =5.774, P<0.05).For patients in coma, the safe indwelling time over 10 days in the half-dose group was 4.25% and 0.00% in the full-dose group, which was significantly higher (χ2 =6.720, P<0.05).The number of cases with vessel damage was 25 cases in degreeⅠ, 21 in degreeⅡand 15 in degreeⅢin the full-dose group .The degree of vessel damage was significant sever in the full-dose group than that in the half-dose group (Z=6.469, P<0.05).Conclusions When treating patients with long -term intravenous transfusions, the retention time of indwelling needles should be paid attention , especially for the unconscious , comatose or the elderly patients .At the meantime , nurses should improve the nursing care of patients ’ skin, and prevent the vessel from the medication damage , and promote the phase of patients ’ recovery .
