院前急救联合绿色通道模式对重型颅脑损伤患者抢救时间及术后康复的影响  

Effect of pre-hospital emergency treatment combined with green channel mode on rescue time and postoperative rehabilitation in patients with severe craniocerebral injury

作　　者：范国晖 高帆[1] 张志启 李金兰 刘玥[1] FAN Guo-hui;GAO Fan;ZHANG Zhi-qi;LI Jin-lan;LIU Yue(Department of Emergency,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450005,Henan,CHINA)

机构地区：[1]郑州大学第二附属医院急诊科,河南郑州450005

出　　处：《海南医学》2024年第17期2553-2558,共6页Hainan Medical Journal

基　　金：2022年度河南省医学科技攻关计划联合共建项目(编号:LHGJ20220509)。

摘　　要：目的探讨院前急救联合绿色通道模式对重型颅脑损伤患者抢救时间及术后康复的影响。方法选取2021年5月至2023年12月于郑州大学第二附属医院就诊的134例重型颅脑损伤患者纳入研究,根据入院时间分组,其中2021年5月至2022年9月就诊的67例重型颅脑损伤患者纳入对照组,采用常规院前、院内急救护理;2022年10月至2023年12月就诊的67例重型颅脑损伤患者纳入研究组,给予院前急救联合绿色通道模式。比较两组患者抢救时间(院前急救时间、院内急救时间)、术后康复情况[神经功能缺损评分(NIHSS)、格拉斯哥昏迷评分(GCS)、Barthrl指数(BI)、入住ICU时间、总住院时间]、并发症发生率、预后情况[格拉斯哥预后量表(GOS)]和患者家属的护理满意度。结果研究组患者的院前、院内抢救时间分别为(23.84±5.68)min、(52.62±10.25)min,明显短于对照组的(29.08±8.15)min、(74.98±13.19)min,差异均有统计学意义(P<0.05);出院时研究组患者的NIHSS评分为(10.29±2.69)分,明显低于对照组的(12.08±2.45)分,GCS、BI评分分别为(12.69±1.08)分、(69.84±4.60)分,明显高于对照组的(11.14±1.22)分、(64.32±4.98)分,总住院时间、入住ICU时间分别为(28.68±4.26)d、(6.69±1.38)d,明显短于对照组的(30.74±5.48)d、(7.84±1.59)d,差异均有统计学意义(P<0.05);研究组患者的并发症发生率为5.97%,略低于对照组的14.93%,但差异无统计学意义(P>0.05);研究组患者的预后情况优于对照组,差异有统计学意义(P<0.05);研究组患者家属的护理满意度为97.01%,明显高于对照组的88.06%,差异有统计学意义(P<0.05)。结论院前急救联合绿色通道模式能有效缩短重型颅脑损伤患者抢救时间,促进患者术后康复,改善患者预后,同时提升患者家属护理满意度。Objective To investigate the effects of pre-hospital emergency treatment combined with green channel mode on rescue time and postoperative rehabilitation in patients with severe craniocerebral injury.Methods A total of 134 patients with severe craniocerebral injury who were treated at the Second Affiliated Hospital of Zhengzhou University from May 2021 to December 2023 were selected for the study.They were divided into two groups based on their admission time:67 patients who were treated from May 2021 to September 2022 were included in the control group and received routine pre-hospital and in-hospital emergency care;67 patients who were treated from October 2022 to December 2023 were included in the study group and received pre-hospital emergency combined with a green channel model.The rescue time(pre-hospital emergency care time,in-hospital emergency care time),postoperative re-habilitation(Neurological Impairment scores[National Institute of Health Stroke Scale,NIHSS],Glasgow Coma Scale[GCS],Barthrl Index[BI],ICU admission time,total length of hospital stay),complication rate,prognosis(Glasgow Outcome Scale,GOS),and nursing satisfaction of the patients'family members were compared between the two groups.Results The pre-hospital and in-hospital emergency care time in the study group were(23.84±5.68)min and(52.62±10.25)min,respectively,which were significantly shorter than(29.08±8.15)min and(74.98±13.19)min of the control group(P<0.05).The NIHSS score of patients in the study group at discharge was(10.29±2.69)points,which was significantly lower than(12.08±2.45)points of the control group(P<0.05);the GCS and BI scores were(12.69±1.08)points and(69.84±4.60)points,respectively,which were significantly higher than(11.14±1.22)points and(64.32±4.98)points of the control group(P<0.05);the total length of hospital stay and length of ICU stay were(28.68±4.26)d and(6.69±1.38)d,respectively,which were significantly shorter than(30.74±5.48)d and(7.84±1.59)d of the control group(P<0.05).The complication rate o

关 键 词：重型颅脑损伤 院前急救 绿色通道模式 术后康复 预后 

分 类 号：R473.74[医药卫生—护理学]