刘敏祺 刘秋秋

[摘要]目的 探討围术期标准化护理流程对唤醒状态下手术切除脑功能区胶质瘤患者认知能力及生活能力的影响。方法 选取2017年8月～2019年8月湘雅医院收治在唤醒状态下手术切除脑功能区胶质瘤71例患者，2017年8月～2018年7月收治的35例为对照组，实施常规护理流程，2018年8月～2019年8月收治的36例为观察组，实施围术期标准化护理流程。比较两组术中癫痫、寒颤、憋尿感、口干等不良反应发生率，简易精神状态评分（MMSE）、日常生活能力评分（ADL），患者对护理的满意度。结果 观察组术中不良反应总发生率低于对照组，差异有统计学意义（P<0.05）;观察组术后6个月MMSE、ADL评分高于对照组，差异均有统计学意义（P<0.05）;观察组护理总满意度高于对照组，差异有统计学意义（P<0.05）。结论 围术期标准化护理流程可降低唤醒状态下手术切除脑功能区胶质瘤患者术中不良反应，促进神经功能恢复，提高患者日常生活能力及住院期的护理满意度。

[关键词]标准化护理流程;唤醒状态;脑功能区胶质瘤;认知功能;生活能力

[中图分类号] R473.6          [文献标识码] A          [文章编号] 1674-4721（2020）6（b）-0234-04

[Abstract] Objective To explore the effect of perioperative standardized nursing procedures on the cognitive ability and living ability of patients with surgically resected brain functional gliomas under arousal state. Methods A total of 71 patients with gliomas underwent surgical removal of gliomas in the awake state in Xiangya Hospital from August 2017 to August 2019 were selected， from August 2017 to July 2018， 35 cases were used as the control group， and the routine nursing process was implemented. From August 2018 to August 2019， 36 cases were used as the observation group， and the perioperative standardized nursing process was implemented. The incidence of epilepsy， chills， urinalysis， dry mouth and other adverse reactions， the simple mental state score （MMSE）， the daily living ability score （ADL）， and the patients′ satisfaction with nursing were compared between the two groups. Results Total incidence of adverse reactions in the observation group was lower than that in the control group， and the difference was statistically significant （P<0.05）. The MMSE and ADL scores of patients in the observation group at 6 months after operation were higher than those in the control group， and the differences were statistically significant （P<0.05）. Patients in the observation group had higher total satisfaction with care than the control group， and the difference was statistically significant （P<0.05）. Conclusion The standardized perioperative nursing process can reduce the intraoperative adverse reactions of patients with gliomas resected in brain function area under arousal state， promote the recovery of nerve function， improve the patients′ daily life ability and nursing satisfaction during hospitalization.

[Key words] Standardized nursing processes; Awake state; Brain glioma; Cognitive function; Survival skills

手术切除是治疗脑功能区胶质瘤的主要方法，在术中麻醉唤醒状态下手术能降低手术对脑功能区的损伤，是目前国内外研究热点[1-2]。该手术顺利完成的关键在于术中清醒患者与术者密切配合[3]，为此术前对患者详细宣教指导及术中唤醒状态下医护配合至关重要，术后优质护理亦是手术疗效的保障。常规围术期护理不能满足该患者手……