The Study On The Application Effect Of Oral Drop Nursing With Hypotonic Saline To The Light Coma Female Patients With Hypertensive Cerebral Hemorrhage

Objective: To observe the oral microenvironment change of patients through the intermittent oral drop of 0.45% hypotonic saline to the light coma female patients with hypertensive cerebral hemorrhage,and explore the effects of this nursing measure on the operation time of oral odor and oral care,the occurrence of hypostatic pneumonia,the retention time of gastric tube,and the discharge of stool in the first week after patient intervention,and to provide a basis for improving the oral nursing effects on the light coma female patients with hypertensive cerebral hemorrhage.Methods:1.The method to select the research objects60 light coma female patients eligible for inclusion with hypertensive cerebral hemorrhage admitted to the department of neurosurgery from January to December 2018 were selected,and the patients were randomly divided into the experimental group and the control group by random number table and the hospitalization sequence number.32 patients in the experimental group and 28 patients in the control group.The status of consciousness,age,amount of bleeding,history of hypertension,and history of cerebrovascular disease were recorded in the two groups.2.The intervention method in two groupsThe control group used a disposable oral care kit to perform routine oral care on the patient(large cotton balls took 0.9% saline to wipe the oral cavity)twice daily,once in the morning and afternoon.On the basis of twice-daily oral care,the experimental group was given oral drop intermittently with 0.45% hypotonic saline at different times of the day.The drop time was before oral care and 30 minutes before breakfast,3-5 times between meals,and 3-5 intermittent oral drops in night shift,each for 10 minutes.The amount of drops depends on the patients' swallowing.On the seventh day after intervention,the patients' oral odor status oral?nursing operation time ?the occurrence of hypostatic pneumonia? the retention time of gastric tube and the discharge of stool were observed and counted.3.The statistical analysis methodSPSS21.0 statistical software was used for data analysis.Among the observation of variables of the two group,the count data were described by frequency and percentage.The hypothesis test was performed by using the ?2 test or the four-table exact probability method of complete random design between the two groups.The mean ± standard deviation was used for the description of measurement data and the group t test was used for group comparison.Results: 1 The withdrawal of subjects from two groups.There were 6 patients withdrew from the study,two of them lost contact because of transfer,one asked for withdrawal without reason,and three died and withdrew from the study.There was no statistical difference in withdrawal between the experimental group and the control group(2 = 0.067,P = 0.796).2 The basic characteristics of two groups.The age of the cases in the experimental group was(56.28±8.34)years,and the age of the cases in the control group was(59.47±7.06)years,the amount of bleeding was(35.6±2.3)ml in the experimental group,(36.7±2.4)ml in the control group;GCS was(12.62±2.11)in the experimental group,and(12.24 ±2.18)in the control group,there were no statistical difference between the two groups in terms of age,bleeding volume,Glasgow score,history of hypertension and history of cerebrovascular etc(P>0.100).3 The comparison of oral nursing effect on the light coma female patients with hypertensive cerebral hemorrhage between two groups 3.1 The comparison of oral odor between two group after interventionThere were 13 cases of oral odor in the experimental group,accounted for 46.43%,20 cases of oral odor in the control group,accounted for 76.92%.There was statistical difference between two groups(P =0.022).3.2 The comparison of oral nursing time between two groupsThe time of oral nursing of the experimental group was 10±2min,the oral nursing time of control group was 16±1.5min.There was statistical difference between two groups(P =0.000).3.3 The comparison of the occurrence of hypostatic pneumonia between two groupsThere were 3 cases with hypostatic pneumonia in the experimental group,accounted for 10.71%,there were 10 cases with hypostatic pneumonia in the control group,accounted for 38.46%.There was statistical difference between two groups(P =0.017).3.4 The comparison of the retention time of gastric tube between two groupsThe time of the retention time of gastric tube was 6±1.4d in the experimental group,while 12±2.1d in the control group.There was statistical difference between two groups(P =0.000).3.5 The comparison of the discharge of stool in the first week after intervention between two groupsThere were 7 cases discharged stool in the first week after intervention in the experimental group,accounted for 26.92%,while 1 case in the control group,accounted for 3.57%.There was statistical difference between two groups(P =0.031).Conclusions:1.The oral drop of hypotonic saline improved the oral hygiene of the light coma female patients with hypertensive cerebral hemorrhage,and decreased the occurrence of hypostatic pneumonia.2.The oral drop of hypotonic saline contributed to the recovery of function of swallowing and gastrointestinal tract of the light coma female patients with hypertensive cerebral hemorrhage.3.The oral drop of hypotonic saline reduced the operation time of oral care for the light coma female patients with hypertensive cerebral hemorrhage and increased work efficiency of nursing staff.