急性重症脑卒中患者的监护及其意义

徐善芬　崔智娟　吴远美

摘要：在神经内科常规护理的基础上，对36例重症脑卒中患者中的14例施行监护，另22例作为对照。两组患者的一般情况包括年龄、开始治疗时间、既往病史评分和入院时的NIHSS评分及Glasgow评分均无显著差别(P>0.05)。结果发现，监护组的死亡率为7.14%，较对照组18.18%有显著降低(P<0.01)；监护组所需住院治疗时间为(20.34±2.45)d，与对照组(32.24±3.23)d相比明显缩短(P<0.05)；虽然两组患者在入院后2周HIHSS评分无显著差异(P>0.05)，但4周后两组NIHSS评分相差显著(P<0.01)，提示监护组有着较好预后。以上结果表明，对重症脑卒中患者施行监护有着比较重要的意义。
关键词：脑血管意外； 监护； 护理
中图分类号：R473.5　　文献标识码：A　　文章编号：1008-9993(2000)05-0022-02

Intensive Care of Acute Severe Stroke Patients and Its Significance

XU San-feng　CHUI Zhi-juan　WU Yuan-mei
(No.2 Department of Medicine,No.422 Hospital of PLA,Zhanjian 524005,China)

Abstract:Thirty-six patients with severe stroke were randomly divided into two groups.There was no significant difference in the general status of patients between the two groups(P>0.05).One group(n=14) was put on intensive care(IC),while the other group(n=22) receiving routine nursing(RN) was used as control.The death rate of patients on IC was 7.14%,which was significantly lower than that of control(P<0.01).In addition,patients under IC needed shorter periods of hospital stay than did the control(P<0.05).Although the NIHSS scores of patients on IC and those receiving RN were not significantly different at 2 weeks of hospital stay(P>0.05),patients on IC began to get significantly lower NIHSS scores than control at 4 weeks (P<0.01),indicating that patients on IC rehabilitated faster and better.These results demonstrated that it is necessary to put patients with severe stroke on IC.
Key words:stroke; intensive care; nursing

　　脑卒中是老年人常见病，亦是危及人类生命的主要疾病之一，而重症脑卒中的死亡率则更高。因而，对重症脑卒中的急诊监护和护理也就显得更为重要。据报道［1］，重症脑卒中的监护能有效地改善预后，减少并发症，缩短住院时间。现就我院1997年至1999年间收治的36例重症脑卒中患者的护理体会报告如下：

1　对象和方法

1.1　对象　1997年1月至1999年12月间，我院收治的急性脑卒中患者共76例，经NIHSS评分，其中重症脑卒中36例，男25例，女11例，年龄在51～58岁之间，平均(65.12±8.23)岁。其中，脑出血12例，脑梗死24例，所有病例都经头颅CT检查证实。具体发病部位如下：丘脑出血2例，基底节区出血6例，外囊出血2例，小脑出血2例，大面积大脑中动脉区梗死2

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