摘要
目的探讨基层医院建立神经外科重症监护室(NSICU)对重型颅脑创伤患者救治的影响。方法回顾性纳入2014 年1 月—2014 年12 月及2016 年1 月—2017 年11 月广东省中西医结合医院神经外科重症监护室建立前后收治的93 例重型颅脑创伤患者。将患者分为对照组(NSICU 建立前)及观察组(NSICU 建立后),根据出院时患者的死亡率、抢救成功率及并发症发生率等指标,评估基层医院建立神经外科重症监护室及制定工作策略对重型颅脑损伤患者救治的影响。结果( 1)对比死亡率,对照组患者共 14 人入组,死亡 5 人,死亡率35.71%;观察组患者共40 人入组,死亡6 人,死亡率15.00%;比较差异有统计学意义(P < 0.05)。(2)对比抢救成功人数,对照组共抢救20 人/次,成功15 人/次;观察组共抢救58 人/次,成功52 人/次;比较差异无统计学意义(P > 0.05)。(3)对照组患者共14 人,伴有并发症14 例,并发症发生率100%;观察组患者共40 人,伴有并发症38 例,并发症发生率95%。比较差异无统计学意义(P = 0.135 > 0.05)。结论从结果可以看出,设立神经外科重症监护病房可明显降低重型颅脑损伤患者的死亡率。
Objective To investigate the effect of establishing Neurosurgical Intensive Care Unit (NSICU) in primary hospitals on the treatment of patients with severe traumatic brain injury (TBI). Methods 93 patients with severe TBI were included in the retrospective study of the treatment before and after the NSICU was established in Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine. The patients are divided into two groups: one is the control group (before the establishment of NSICU), and the other is the observation group (after the establishment of NSICU). The study period of the control group was from January 2014 to December 2014 and that of the observation group was from January 2016 to November 2017. The effect of establishing NSICU and making work strategies in primary hospitals on the treatment of patients with severe TBI is evaluated based on the mortality and the survival rate of rescue and the complication rate of the patient at the time of discharge. Results (1) In terms of the mortality, 5 out of 14 admitted patients in the control group died, and the mortality rate was 35.71% while in the observation group, 6 out of 40 admitted patients died, and the mortality rate was 15%. The difference was statistically significant (P < 0.05).(2) In terms of the number of successful rescuers, 15 people/time out of 20 people/time were successfully rescued in the control group while in the observation group, 52 people/time out of 58 people/time were successfully rescued. The difference was not statistically significant (P > 0.05).(3) In terms of the complication rate, 14 out of 14 patients in the control group developed complications, a complication rate of 100%, while in the observation group, 38 out of 40 patients developed complications, an complication rate of 95%. The difference was not statistically significant (P 0.135 > 0.05). Conclusion From the results, it is obvious that the establishment of NSICU can significantly reduce the mortality of patients with severe TBI.
作者
刘德亮
李嘉荣
区学明
孔祥波
刘平文
LIU Deliang;LI Jiarong;OU Xueming;KONG Xiangbo;LIU Pingwen(Department of Neurosurdery, Guangdong Province Hospital of IntegratedTraditional Chinese and Western Medicine, Foshan Guangdong 528200,.China)
出处
《中国继续医学教育》
2019年第26期51-54,共4页
China Continuing Medical Education
基金
广东省佛山市科学技术局自筹经费类科技计划项目(2016 AB001112)
关键词
重型颅脑创伤
神经外科重症监护室
策略
效果
颅内压监测
死亡率
severe traumatic brain injury (TBI)
NSICU
strategy
effect
intracranial pressure monitoring
death rate
