标题：基于目标设置理论的护理干预在植物人颅内电极植入术中的应用

      作者：罗针，崔翱，唐敏，赵小燕
    (四川大学华西医院神经综合科，四川 成都 610041)

      卷次： 2016年27卷4期

      【摘要】 目的 分析基于目标设置理论的护理干预在植物人颅内电极植入术中的应用效果。方法 选取
2012年8月至2014年8月间在本院接受治疗的植物生存状态患者30例作为研究对象，均接受颅内电极植入术。根
据接受的护理干预措施不同，所有入组患者分为观察组及对照组，每组各15例。对照组患者接受植物人常规护理，
观察组患者接受基于目标设置理论的护理干预，随访并记录两组患者的治疗预后、术后并发症发生情况，采用酶联
免疫吸附法(ELISA)检测血清神经损伤指标水平。结果 (1)两组患者接受颅内电极植入术后1年内，观察组患者
中的死亡比例低于对照组[6.7% (1/15) vs 13.3% (2/15)]、唤醒比例高于对照组[20.0% (3/15) vs 6.7% (1/15)]，差异均有
统计学意义；(2)观察组患者接受基于目标设置理论的护理干预后，术后颅内出血、脊髓损伤、颅内感染、肺部感染等并
发症发生率均明显低于对照组，差异均有统计学意义[0 (0/15) vs 13.3% (2/15)、0 (0/15) vs 13.3% (2/15)、6.7% (1/15)
vs 26.7% (4/15)、13.3% (2/15) vs 40.0% (6/15)，P<0.05]；(3)观察组患者接受基于目标设置理论的护理干预后，血清
神经元特异性烯醇化酶(NSE)、β淀粉样蛋白(Aβ)、星形胶质源性蛋白(S100β)等脑损伤指标水平值均明显低于对
照组，差异均有统计学意义 [(20.28±4.36) μg/L vs (37.63±6.87) μg/L、(10.92±1.72) μg/L vs (24.31±3.39) μg/L、
(0.101±0.018) μg/L vs (0.165±0.027) μg/L，P<0.05]。结论 基于目标设置理论的护理干预应用于植物人颅内电极植
入术中可以有效优化患者的治疗预后、减少术后并发症发生，保护患者的脑组织免收损伤，具有积极的临床意义。

      【关键词】 植物人；颅内电极植入术；目标设置理论；护理干预

      【中图分类号】 R473.6 【文献标识码】 A 【文章编号】 1003—6350（2016）04—0686—03


Application of nursing intervention based on Goal Setting Theory in vegetative state patients undergoing
intracranial electrode implantation.
LUO Zhen, CUI Ao, TANG Min, ZHAO Xiao-yan. Department of Comprehensive
Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, CHINA

【Abstract】 Objective To analyze the effect of nursing intervention based on Goal Setting Theory in vegetative
state patients received intracranial electrode implantation. Methods Thirty vegetative state patients in our hospital
from August 2012 to August 2014 were chosen as research subjects, All patients underwent intracranial electrode implan-
tation. Depending on different nursing interventions, the patients were divided into observation group and control group,
each with 15 patients. Patients in the control group received routine nursing care, while the patients in the observation
group received nursing intervention based on Goal Setting Theory. During the follow-up, the treatment outcomes, complica-
tions, levels of serum nerve damage indicators (detected by ELISA) were recorded and compared. Results (1) One year
after treatment, the proportion of deaths in the observation group was significantly lower than that in the control group
[6.7% (1/15) vs 13.3% (2/15)], and the proportion of wake in the observation group was significantly higher [20.0% (3/
15) vs 6.7% (1/15)], P<0.05. (2) The incidences of intracranial hemorrhage, spinal cord injury, intracranial infections,
lung infections and other complications in the observation group were significantly lower than those in the control group
[0 (0/15) vs 13.3% (2/15), 0 (0/15) vs 13.3% (2/15), 6.7% (1/15) vs 26.7% (4/15), 13.3% (2/15) vs 40.0% (6/15), P<
0.05]. (3) The serum levels of neuron-specific enolase (NSE), amyloid β-protein (Aβ), S100β in the observation group
were significantly lower than those in the control group [(20.28±4.36) μg/L vs (37.63±6.87) μg/L, (10.92±1.72) μg/L vs
(24.31±3.39) μg/L, (0.101±0.018) μg/L vs (0.165±0.027) μg/L, P<0.05]. Conclusion Applying nursing intervention
based on Goal Setting in vegetative state patients receiving intracranial electrode implantation can effectively optimize
prognosis of patients, reduce postoperative complications, protect the brain tissue of patients from injury, which has posi-
tive significance.

      【Key words】 Vegetative state patient; Intracranial electrode implantation; Goal Setting Theory; Nursing intervention
·护 理·
6350.2016.04.062