摘要
目的探讨神经外科重症监护单元(NICU)患者的治疗管理模式对疗效的影响。方法以本NICU实行NICU专职医生管理时间2015年8月3日为节点,将2015年2月3日—2016年2月3日收治的NICU住院患者分为非NICU专职医生管理(NNPDI)组和NICU专职医生管理(NPDI)组,分别由非专职医生和专职医生主导NICU患者的诊疗工作。对患者住院时间、并发症及预后等进行比较。结果 NPDI组患者平均住NICU时间较NNPDI组延长,水电解质失调发生率低于NNPDI组(P<0.05);2组间呼吸机相关性肺炎、肝肾功能异常、颅内感染、应激性溃疡等的发生率差异无统计学意义(P>0.05)。NPDI组转诊至其他病区比例及病死率低于NNPDI组,出院率高于NNPDI组(均P<0.05);2组间自动出院率差异无统计学意义(P>0.05)。结论 NICU专职医生管理可能在一定程度上改善神经外科重症患者的预后,但在多数并发症的管理中尚未体现出明显优势,专业化管理水平仍有待提高。
Objective To explore the implementation styles on the therapeutic effects on the neurosurgical intensivecare unit(NICU)patients.Methods Patients were enrolled during February3,2015to February3,2016.The key pointtime was August3,2015when the treatment in our NICU was fully implemented by NICU professional doctors.Based on thistime point,all the enrolled patients were divided into non-NICU professional doctor implementing(NNPDI)group and NICUprofessional doctor implementing(NPDI)group.Thus non-NICU professional doctors and professional doctors were theleaders of diagnosis and treatment in tow groups.The length of hospital stay,complications,prognosis and other therapeuticoutcomes were compared between two groups.Results The length of hospital stay was longer in NPDI group than that inNNPDI group(P<0.05).The incidence of water-electrolyte imbalance was lower in NPDI group than that in NNPDI group(P<0.05).There were no significant differences in the incidence of the ventilator-associated pneumonia(VAP),the hepaticand renal insufficiency,the intracranial infections and stress ulcers between the two groups(P>0.05).The proportion ofreferral to other wards and fatality rate were both lower in NPDI group than those in NNPDI group(P<0.05).And thedischarge rate from NICU was higher in NPDI group than that of NNPDI group(P<0.05).There was no significant differencein the rate of patients left hospital without treatment between the two groups(P>0.05).Conclusion The NICU professionaldoctor implementing may be contribute to,at least in part,the improving of prognosis of NICU patients without obviousadvantages in most complications.The level of professional management remains to be improved.
作者
郭林月
王鹏
高闯
苏万强
黄金浩
钱宇
王佳琪
龚之涛
宋一鸣
孙健
江荣才
GUO Lin-yue;WANG Peng;GAO Chuang;SU Wan-qiang;HUANG Jin-hao;QIAN Yu;WANG Jia-qi;GONG Zhi-tao;SONG Yi-ming;SUN Jian;JIANG Rong-cai(Tianjin Medical University, Tianjin 300070, China;Department of Neurosurgery,Tianjin Medical University General Hospital)
出处
《天津医药》
CAS
2017年第8期833-837,共5页
Tianjin Medical Journal
基金
国家自然科学基金资助项目(81671221
81271359)
天津市科技计划项目(14ZCZDSY00179)
关键词
水电解质失调
预后
神经外科重症监护单元
治疗
病死率
water-electrolyte imbalance
prognosis
neurosurgical intensive care unit (NICU)
treatment
case fatality rate
作者简介
郭林月（1991），男，硕士在读，主要从事神经外科研究;通讯作者E-mail:jiang116216@163.com
