规范化早期活动流程在重症蛛网膜下腔出血脑室外引流患者中的应用  

Application of standardized early physical activity in patients with extra-ventricular drainage of severe Subarachnoid Hemorrhage

作　　者：魏丽丽[1] 韩斌如[2] WEI Lili;HAN Binru(Neurosurgical Department,Xuanwu Hospital,Capital Medical University,Beijing,100053,China)

机构地区：[1]首都医科大学宣武医院神经外科,北京市100053 [2]首都医科大学宣武医院护理部,北京市100053

出　　处：《中国护理管理》2020年第4期613-618,共6页Chinese Nursing Management

摘　　要：目的:分析规范化早期活动流程在重症蛛网膜下腔出血脑室外引流中的应用效果。方法:选取2019年1-6月宣武医院神经外科ICU收治的30例患者作为实验组,实施规范化早期活动流程;选取2018年7-12月收治的重症蛛网膜下腔出血脑室外引流30例患者作为对照组,给予脑室外引流常规护理,观察两组患者的恢复及并发症发生情况。结果:活动前、后患者心率逐渐加快(P<0.05)。实验组机械通气时间[(8.50±7.58)dvs(13.57±8.51)d]、脑室外引流时间[(5.77±3.48)dvs(9.00±5.60)d]、ICU住院时间[(14.23±10.87)dvs(20.47±10.83)d]、整体住院时间[(14.90±10.67)dvs(23.23±11.49)d]均缩短(P<0.05)。实验组呼吸机相关性肺炎(13.3%vs36.7%)、下肢深静脉血栓(16.7%vs40.0%)发生率均降低(P<0.05)。结论:规范化早期活动流程能够促进重症蛛网膜下腔出血脑室外引流患者的恢复,减少并发症的发生,有助于患者早期康复。Objective: To evaluate the effect of standardized early physical activity in patients with extra-ventricular drainage of Severe Subarachnoid Hemorrhage(SAH). Methods: Following consecutive sampling, thirty patients admitted to the ICU between January and June, 2019 were selected as the experimental group in which standardized early physical activities were implemented among enrolled patients. Thirty patients who were admitted to the ICU with severe SAH and extraventricular drainage between July and December, 2018 were selected as the control group in which routine care was followed. Patients’ clinical outcomes such as the length of mechanical ventilation, drainage time, days of ICU and hospital stay, as well as related complications were compared between groups. Results: Patient’s heart rate increased gradually before and after implementation of physical exercise(P<0.05). The length of mechanical ventilation [(8.50±7.58) vs(13.57±8.51)], extra-ventricular drainage time [(5.77±3.48) vs(9.00±5.60)], the days of ICU stay [(14.23±10.87) vs(20.47±10.83)] and the overall hospital stay [(14.90±10.67) vs(23.23±11.49)] among patients in the experimental group were significantly shortened compared to those in the control group(P<0.05). In addition, the incidence of ventilator-associated pneumonia(13.3% vs 36.7%) and deep venous thrombosis(16.7% vs 40.0%) were significantly reduced among patients in the experimental group(P<0.05). Conclusion: Standardization of early physical activity implementation can promote patients’ recovery from severe SAH, reduce risks for developing related complications, and encourage early recovery.

关 键 词：规范化 早期活动流程 蛛网膜下腔出血 脑室外引流 

分 类 号：R47[医药卫生—护理学]