Risk prevention and control strategies for nursing in intracranial pressure monitoring of neurocritical patients and their effectiveness
神经重症患者颅内压监测护理风险防控策略及效果研究

摘要

目的 探究神经重症病人颅内压（ICP）监测中护理风险的发生特点及护理风险管理措施对预防护理风险的效果，以期为临床规范化颅内压监测护理管理提供证据参考。方法 2021年06月-2023年06月在本院神经重症监护病房（NICU）行有创颅内压监测的病人共120例，随机分为对照组（常规护理，60例）、观察组（风险防控护理干预方案，60例）。对比两组病人颅内压力变化规律性，术后并发症，中医症候积分，肝脾CT比值，脂肪受控衰减参数（CAP），腰围（WC），体重指数（BMI），肝功能检测[谷丙转氨酶（ALT），谷草转氨酶（AST），谷氨酰转肽酶（GGT）]和血脂检测[总胆固醇（TC），甘油三酯（TG），低密度脂蛋白（LDL-C）]差异。结果 试验组病人的颅内压异常波动率，导管相关并发症的发生率以及发生感染的发病率明显低于对照组（P＜0.05）。干预后观察组中医证候评分相较于对照组有显著好转，肝脾CT比值、CAP值逐步恢复正常水平，WC、BMI及ALT、AST、GGT、TC、TG、LDL-C数值均好于对照组（P<0.05）。结论 系统化的护理风险管理方法可以有效的减少神经系统重症病人脑压监测的风险，有利于病人机体代谢状况和肝功能状况的优化，值得推广使用。

Abstract

Objective To explore the characteristics of nursing risks in intracranial pressure (ICP) monitoring of neurocritical patients and the effect of nursing risk management measures on preventing nursing risks, with the aim of providing evidence reference for the clinical standardized management of intracranial pressure monitoring nursing.
Methods A total of 120 patients with invasive intracranial pressure monitoring in the neurointensive care unit (NICU) of our hospital from June 2021 to June 2023 were randomly divided into the control group (conventional nursing, 60 cases) and the observation group (risk prevention and control nursing intervention plan, 60 cases). The changes in intracranial pressure patterns, postoperative complications, TCM syndrome scores, liver and spleen CT ratios, fat controlled attenuation parameters (CAP), waist circumference (WC), body mass index (BMI), liver function tests [aspartate aminotransferase (ALT), alanine aminotransferase (AST), gamma-glutamyl transpeptidase (GGT)], and lipid tests [total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL-C)] were compared between the two groups.
Results The abnormal fluctuation rate of intracranial pressure, the incidence of catheter-related complications, and the incidence of infection in the experimental group were significantly lower than those in the control group (P < 0.05). After intervention, the TCM syndrome score of the observation group was significantly better than that of the control group, and the liver and spleen CT ratios, CAP values gradually returned to normal levels, while WC, BMI, ALT, AST, GGT, TC, TG, and LDL-C values were better than those of the control group (P < 0.05).
Conclusion   Systematic nursing risk prevention and control methods can effectively reduce the risks of brain pressure monitoring in neurocritical patients, which is conducive to the optimization of the patient's metabolic status and liver function status, and is worthy of promotion and application.