Application of targeted nursing in postoperative patients undergoing cranial defect repair after decompressive craniectomy for traumatic brain injury

Abstract

Objective To explore the application effect of targeted nursing in postoperative patients undergoing cranial defect repair after decompressive craniectomy for traumatic brain injury and the impact on the postoperative complications. Methods From January 2017 to December 2018, 400 patients who underwent cranial defect repair after decompressive craniectomy for traumatic brain injury in Department of Neurosurgery, the First Bethune Hospital-Division Ⅱ were selected and randomly divided into observation group (n=200) and control group (n=200) . The control group received routine nursing, while the observation group received targeted nursing. Scores of the Glasgow Coma Scale (GCS) , National Institutes of Health Stroke Scale (NIHSS) and Face Rating Scale (FRS) , the interval between decompressive craniectomy and cranial defect repair , extubation time, suture removal time, hospitalization time and incidence of complications, scores of Glasgow Outcome Score (GOS) and Karnofsky Performance Status (KPS) were compared between the two groups. Results The NIHSS score and FRS score of both groups decreased, while the GCS score increased, and the observation group was better than the control group, the differences were statistically significant (P<0.05) . The interval time between the two kinds of operations, extubation, suture removal and hospitalization time after cranial defect repair were shorter in the observation group than in the control group (P<0.05) . The incidence of complications in the observation group was 6.00%, which was lower than 13.50% in the control group (P<0.05) . The ratio of GOS score between 4 to 5 of the observation group was 79.50%, which was higher than 69.00% of the control group, and the rate of low scores of the observation group was lower than that of the control group (P<0.05) . The KPS score of the observation group was higher than that of the control group (P<0.05) . Conclusions Application of targeted nursing in postoperative patients undergoing cranial defect repair after decompressive craniectomy for traumatic brain injury can improve their GCS, GOS, KPS scores, reduce their NIHSS scores and complications, shorten the interval time between cranial defect repair and decompressive craniectomy, extubation time, suture removal time and hospitalization time and moreover better connect the two operations. Key words: Craniocerebral trauma; Decompressive craniectomy; Cranial defect repair; Complications; Targeted nursing care