| Background With the sustainable development of social modernization,motor vehicles,high buildings continue to increase,an increasing number of accidents caused by traffic,construction and others lead to increased incidence of traumatic brain injury.According to statistics,the annual incidence of craniocerebral injury in China is 100 to 200 per 100,000 people,of which 18%-20% of patients with severe brain injury,and the death rate is about 30%-50%.Although the rapid development of medical treatment before the hospital,significantly reduced the mortality of patients with traumatic brain injury,the coma caused by these patients are increasing year by year.Longtime comatose will lead to a variety of systemic complications,the higher risk of death and disability in patients,so that making coma patients awake in the clinical is of significant significance.In general,coma patients can quickly wake up from comatose after a certain awakening treatment,indicating a good prognosis of the patient.Therefore,how to shorten the comatose time of the patients on the basis of clinical treatment,the maximum compensation and recovery of its damaged function can be a hot problem of the current brain injury treatment.Objective 1.To investigate the effect of music therapy on consciousness for patients with coma caused by traumatic brain injury.2.To study and observe the effect of music therapy on awaking up coma patients with traumatic brain injury.3.To explore an effective nursing intervention measure in waking patients with coma caused by traumatic brain injury early.Methods Clinical data of 40 patients with traumatic brain injury hospitalized in the emergency department,Southwest Hospital of the Army Military Medical University,from January 2016 to December 2016 were collected,which were still unconscious after the emergency surgery.These patients were randomly divided into the therapy and control groups.And statistics its demographic data and clinical features.The control group received conventional treatment and nursing care,and received hyperbaric oxygen therapy after stabilization on the 7th day of admission.the therapy group took the music therapy on the basis of the conventional treatment after they were hospitalized 7 days,the music therapy made specific music prescriptions according to each patient’s preference,repeat play 3 times a day,respectively,in the morning,afternoon and evening,30 minutes each time.Also record the treatment group before and after music therapy of patients with heart rate,respiration,blood pressure,and continued 4 weeks.Using the Glasgow Coma Scale(GCS),the JFK coma recovery scale(CRS-R)respectively before and after therapy in first,second,third,and forth weeks for two groups of patients were evaluated,and count up the sober patients of two groups,at the same time record the awake time.Result 1.At the time of admission,the two groups’ differences in baseline data of patients with coma was not statistically significant(P > 0.05);2.During the music therapy in treatment group,there were 18 cases with heart rate increasing,16 cases with accelerated breathing,18 cases with elevation of blood pressure.The difference was statistically significant through compared with those before the treatment(P < 0.05);3.The scores before and after treatment in first,second weeks,have no statistical significant difference between therapy group and control group(P > 0.05);and after the therapy group have took music therapy for three weeks,the scores were obviously higher than the control group,which difference was statistically significant(P < O.05);And by the fourth week after treatment,therapy group’s GCS and CRS-R scores were obviously higher than the control group,also the statistical difference was obviously significant(P < 0.01);4.The results analyzed by the day after 4 weeks’ treatment,showed that the therapy group had 13 cases awake,the awake rate was 65.0%,and the control group had 6 cases awake,the awake rate was 30.0%.The rate of sober patients’ difference between two groups was statistically significant(P<0.05);The awake time of treatment group was significantly shorter than that of control group,which difference between the two groups was statistically significant(P<0.05).Conclusion 1.With the premise that it is no significant difference in patient on the condition and injury degree at the time of admission,treatment plan,medication after admission,at least 3 weeks of music therapy,can improve coma patients by traumatic brain injury with consciousness disorders;2.Sober patients during the period of music therapy appear the heart and breathing rate speeding up,also blood pressure rising,that prompt appropriate music had an effect on physiological indexes of coma patients,which had a synergistic effect on improving awareness levels;3.After 4 weeks’ music treatment,awakening effect is obvious,the rate of sober patients was increased,and the awakening time was more significantly shorten. |
