音乐疗法联合五感促醒疗法在颅脑损伤术后昏迷患者护理中的应用

摘要/Abstract

摘要： 目的探讨颅脑损伤（TBI）术后昏迷患者应用音乐疗法联合五感促醒疗法的效果。方法选取2022年1月—2023年6月聊城市第二人民医院收治96例TBI术后昏迷患者,按照干预方法的不同将患者分为干预组和对照组,每组48例。对照组给予常规护理,干预组给予音乐疗法联合五感促醒疗法,比较两组苏醒情况、意识状态、神经功能及并发症。结果干预组开始干预至清醒时间短于对照组,苏醒率高于对照组,差异有统计学意义（P<0.05）;出院时,两组格拉斯哥昏迷量表、全面无反应评分量表评分均高于入院时,且干预组高于对照组,差异有统计学意义（P<0.05）;出院时,两组美国国立卫生研究院卒中量表评分均低于入院时,且干预组低于对照组,差异有统计学意义（P<0.05）;干预组并发症发生率低于对照组,差异有统计学意义（P<0.05）。结论音乐疗法联合五感促醒疗法应用于TBI术后昏迷患者干预中,能够改善意识状态与神经功能,促进患者苏醒,预防并发症发生。

关键词: 颅脑损伤, 术后昏迷, 音乐疗法, 五感促醒疗法

Abstract: Objective To explore the effect of music therapy and five senses awakening therapy on postoperative coma patients with TBI. Methods A total of 96 postoperative comatose patients with TBI from January 2022 to June 2023 who were admitted in the Second People's Hospital of Liaocheng City were selected, and divided into the intervention group (n=48, music therapy and five sensory awakening therapy) and the control group (n=48, routine care) by different intervention methods. The awakening status, consciousness status, neurological function, and complications in both groups were compared. Results In comparision of the control group, the start intervening to wakefulness time of the intervention group was shorter (P<0.05), and the awakening rate was higher (P<0.05). At discharge, the GCS and FOUR scores in both groups were elevated (P<0.05), and in comparision of the control group, the intervention group was higher (P<0.05). At discharge, NIHSS scores in both groups were decreased (P<0.05), and in comparision of the control group, the intervention group was lower (P<0.05). In the incidence of complications, in comparision of the control group, the intervention group was lower (P<0.05). Conclusion The combination of music therapy and five senses awakening therapy can improve consciousness and neurological function, promote patient recovery, and prevent complications in the intervention of comatose patients after TBI surgery.

Key words: craniocerebral injury, postoperative coma, music therapy, five senses awakening therapy

中图分类号:

R473.5

陈媛媛, 管冬冬, 刘文博, 张跃华. 音乐疗法联合五感促醒疗法在颅脑损伤术后昏迷患者护理中的应用[J]. 中华养生保健, 2024, 42(18): 150-153.

CHEN Yuan-yuan, GUAN Dong-dong, LIU Wen-bo, ZHANG Yue-hua. Application of Music Therapy and Five Senses Awakening Therapy in the Nursing of Postoperative Coma Patients with Traumatic Brain Injury[J]. ZHONGHUA YANGSHENG BAOJIAN, 2024, 42(18): 150-153.

参考文献

[1] 张萍,卢翠,祝玉.以循证理论为基础的针对性护理干预在重度颅脑损伤患者中的应用[J].齐鲁护理杂志,2023,29(1):162-164.
[2] 蒋丽平. 基于循证理念的前瞻性护理干预对重型颅脑损伤患者神经功能、促醒作用及便秘的预防效果[J].国际护理学杂志,2023,42(13):2457-2460.
[3] 王群,王金萍,任茜,等.早期介入镜像疗法联合音乐疗法对缺血性脑卒中后偏瘫患者康复效果的影响[J].中西医结合护理(中英文),2022,8(2):94-96.
[4] 俞士隔,刘勤,张倩.多感觉联合刺激护理对重症颅脑损伤昏迷患者苏醒、神经功能及并发症的影响[J].临床与病理杂志,2023,43(7):1431-1438.
[5] CARNEY N, TOTTEN A M, O’REILLY C, et al. Guidelines for the management of severe traumatic brain injury, fourth edition[J].Neurosurgery,2017,80(1):6-15.
[6] TEASDALE C, JENNETT B.Assesment of coma and impaired consciousness. A practical scale[J].Lanct,1974,2(7872):81-84.
[7] 谭艳华. 唤醒式干预对重度颅脑损伤患者转清醒时间及昏迷指数的影响[J].中外医学研究,2021,19(14):119-121.
[8] WIJDICKS E F, BAMLET W R, MARAMATTOM B V, et al.Validation of a new coma scale: The FOUR score[J]. Ann Neurol, 2005, 58(4):585-593.
[9] Kwah L K, Diong J.National Institutes of Health Stroke Scale(NIHSS)[J].J Physiother,2014,60(1):61.
[10] 张娅丽,周晖,韩芳.Braden压力性损伤风险评估量表对重症颅脑损伤术后昏迷患者压力性损伤发生率的影响[J].国际护理学杂志,2022,41(12):2206-2209.
[11] 刘钰,吕明明,马蓉.呼唤式护理对重型颅脑损伤且伴昏迷患者格拉斯哥昏迷评分的影响[J].中西医结合护理(中英文),2021,7(4):29-32.
[12] 臧珍珍,王永勤,党志霞.音乐疗法联合四感联合促醒刺激护理对高血压性脑出血术后昏迷病人苏醒时间、神经功能及临床预后的影响[J].全科护理,2022,20(4):523-525.
[13] 蔺珊. 持续浅镇静目标导向联合音乐疗法在ICU重症颅脑损伤机械通气患者中的应用效果[J].护理实践与研究,2021,18(9):1351-1354.
[14] 裴晶晶,梅洁,丁艮晓.三维五感促醒疗法联合手厥阴经电刺激在颅脑损伤昏迷患者中的应用[J].齐鲁护理杂志,2023,29(2):17-19.
[15] 杜菊红,孙小妮.集束化护理干预结合感觉刺激对危重症颅脑损伤昏迷患者神经功能、脑电图的影响[J].临床医学研究与实践,2022,7(26):148-150.
[16] 鲁小丽,王运韵,王秀明,等.重型颅脑损伤昏迷患者早期促醒护理干预临床分析[J].中国全科医学,2021,24(S1):219-221.
[17] 官玉蓉,戴夏慧.触听光刺激呼唤法在颅脑损伤昏迷患者中的应用效果[J].护理与康复,2020,19(12):29-31.
[18] 吕梅芬,杨永花,张秀英,等.多感觉联合刺激对颅脑损伤昏迷患者的促醒作用[J].中华物理医学与康复杂志,2020,42(10):896-898.
[19] 张也,陈秋,储韵.多感官促醒护理在脑出血术后昏迷患者中的应用[J].齐鲁护理杂志,2023,29(20):68-71.
[20] 刘杰,成晶晶,姜亦伦.感知唤醒干预对ICU脑性昏迷患者觉醒意识和神经功能的影响[J].国际护理学杂志,2022,41(5):847-850.