摘要
目的 探讨早期高压氧（HBO）联合阶梯式康复护理对昏迷患者的促醒效果。方法 选取2024年1月—2025年5月本院收治的80例创伤性脑损伤昏迷患者，随机分为观察组（HBO+阶梯护理）与对照组（常规护理）各40例。比较两组GCS评分、CRS-R评分、苏醒率及并发症。结果 治疗4周后，观察组GCS评分、CRS-R评分均显著高于对照组（P<0.05）；观察组总有效率显著高于对照组（P<0.05）；并发症发生率观察组显著低于对照组（P<0.05）。结论 早期HBO联合阶梯式康复护理可显著提升昏迷患者苏醒率，改善神经功能，安全性良好。
关键词： 高压氧；阶梯式康复；昏迷促醒；创伤性脑损伤；护理
Abstract
Objective To evaluate the efficacy of early hyperbaric oxygen (HBO) combined with stepwise rehabilitation nursing in awakening coma patients. Methods 80 traumatic brain injury coma patients admitted from Jan 2024 to May 2025 were randomized into observation group (HBO + stepwise nursing, n=40) and control group (routine care, n=40). GCS score, CRS-R score, awakening rate, and complications were compared. Results After 4 weeks of treatment, the GCS score and CRS-R score of the observation group were significantly higher than those of the control group (P<0.05); the total effective rate of the observation group was significantly higher than that of the control group (P<0.05); and the complication rate of the observation group was significantly lower than that of the control group (P<0.05). Conclusion Early HBO combined with stepwise rehabilitation nursing significantly improves awakening and neurological recovery with good safety.
Key words： Hyperbaric oxygen; Stepwise rehabilitation; Coma awakening; Traumatic brain injury; Nursing
参考文献 References
[1] 钱小莉,颜萍.阶梯式康复护理干预在退行性腰椎疾病患者后路腰椎体间融合术围术期的应用效果[J].婚育与健康,2025,31(10):178-180.
[2] 廖舒.阶梯式康复护理干预对脑梗死恢复期患者康复依从性及肢体功能恢复的影响[J].医学信息,2025,38(09): 173-176.
[3] 宋晓,李根.腰椎间盘突出患者的阶梯式康复护理体会[J].婚育与健康,2025,31(08):175-177.
[4] 蔡丹.慢性阻塞性肺疾病（COPD）急性加重期患者阶梯式肺康复护理[A]2025精神医学与心理健康系列研讨会论文集[C].重庆市健康促进与健康教育学会全科专委会, 重庆市健康促进与健康教育学会, 2025: 4.
[5] 彭阳阳,李靖梅.1例自身免疫性脑炎患儿的阶梯式早期重症康复护理[J].当代护士(下旬刊),2025,32(04):71-75.
[6] Jonas A Ipsen, Jan Abel Olsen, Bjarke Viberg, Lars T Pedersen, Inge H Bruun, Eva Draborg. Rehabilitation and care after hip fracture: a cost-utility analysis of stepped-wedge cluster randomized trial[J]. Journal of rehabilitation medicine, 2024, 56 jrm40897.
[7] Nisarga Vinyas,Khar Prerna,Shah Henal.Enhancing child mental health: a stepped care approach by mental health professionals at an early intervention and rehabilitation centre for children, in India[J].Discover Psychology,2024, 4(1):
[8] 王晓雪, 吴艳.探讨阶梯式康复护理在微创腰椎间盘突出患者 Oswestry 腰背 ,下肢功能障碍评分的影响[J].国际护理医学,2024,6(4):
[9] 张洁.重症颅脑损伤昏迷患者早期高压氧治疗的促醒作用研究[J].临床医学,2023,43(09):9-12.
[10] 张琪,尹秀玲,罗娟,朱江珍.重症颅脑损伤昏迷患者早期高压氧（HBO）治疗促醒的临床研究[J].中国当代医药, 2021,28(14):47-49+53.