多学科SUPPORT管理模式干预对脊髓损伤并截瘫患者手术效果的影响  

Effects of Multidisciplinary SUPPORT Management Model Intervention on Patients with Spinal Cord Injury and Paraplegia

作　　者：仇铁英[1] 王卫星[1] 谭晓菊[1] 黄金[2] QIU Tie-ying;WANG Wei-xing;TAN Xiao-ju(Department of spinal surgery,Second Xiangya Hospital of Central South University,Hunan,Changsha,410011,China)

机构地区：[1]中南大学湘雅二医院脊柱外科,湖南长沙410011 [2]中南大学湘雅二医院临床护理教研室,湖南长沙410011

出　　处：《医学临床研究》2020年第1期18-21,25,共5页Journal of Clinical Research

基　　金：中南大学湘雅二医院临床护理科研基金项目(编号2O17-YHL-O2)。

摘　　要：【目的】建立基于多学科团队合作的SUPPORT管理模式,有针对性地对脊髓损伤并截瘫患者进行综合评估和干预,评价该管理模式效果,探索提高护理质量和安全的新方法。【方法】从医疗、护理、康复、营养、心理、中医、高压氧等七个医学学科出发,构建SUPPORT护理模式;通过整合资源,联合多个专科,对2017年1月至2018年12月本院收治的58例脊髓.损伤并截瘫手术患者进行综合干预(观察组)。收集2015年1月至2016年12月本院收治的60例脊髓损伤并截瘫手术常规护理患者作为对照(对照组)。比较两组患者在术前等待时间、术后住院时间、总住院时间、住院费用及术后1个月、3个月、1年死亡率。分析两组患者生活质量评分及患者满意度。【结果】观察组在术前等待时间、术后住院时间、总住院时间、住院费用均明显短于对照组,在术后3个月并发症发生率方面明显少于对照组,差异均有统计学意义(P<0.05)。在满意度总分、医护责任心、服务态度和关系病人程度、出院指导四个方面有明显提高,差异均具有统计学意义(P<0.05),在入院介绍、患者对医院整体态度等两个维度无统计学意义(P>0.05).【结论】SUPPORT管理模式的构建,可以规范脊聽损伤并截瘫患者的医疗治疗和管理,科学地进行护理和健康指导,从而缩短住院时间,提高患者满意度。【Objective】To establish a multidisciplinary teamwork based on SUPPORT management model,comprehensively evaluate and intervene in patients with spinal cord injury and paraplegia,evaluate the effectiveness,quality of living and safety of this management model.【Methods】Starting from seven medical disciplines such as medical treatment,nursing,rehabilitation,nutrition,psychology,traditional Chinese medicine and hyperbaric oxygen,the support nursing mode was constructed;58 patients with spinal cord injury and paraplegia surgery admitted to our hospital from January 2017 to December 2018 were given comprehensive intervention(observation group)by integrating resources and combining multiple specialties.60 patients with spinal cord injury and paraplegia who received routine nursing in our hospital from January 2015 to December 2016 were collected as the control group.The patients in the two groups were compared in waiting time before operation,hospitalization time after operation,total hospitalization time,hospitalization cost and mortality 1 month,3 months and 1 year after operation.The quality of life scores and patients satisfaction were analyzed.【Results】The time of waiting before operation,the time of hospitalization after operation,the total time of hospitalization and the cost of hospitalization in the observation group were significantly shorter than those in the control group,and the incidence of complications in the three months after operation was significantly lower than that in the control group,the difference was statistically significant(P<0.05).The difference was statistically significant(P<0.05).There was no significant difference in the two dimensions of hospital introduction and patients'overall attitude to the hospital(P>0.05).【Conclusion】The construction of Support management mode can standardize the medical treatment and management of patients with spinal cord injury and paraplegia,scientifically carry out nursing and health guidance,so as to shorten the length of stay and improve pat

关 键 词：脊髓损伤/外科学 脊随损伤/并发症 截瘫/病因学 

分 类 号：R651.21[医药卫生—外科学]