神经外科重症患者四级康复护理活动方案的构建及应用  

Construction and application of four-level rehabilitation nursing program for severe neurosurgery patients

作　　者：李曼[1] 张娜芹 王军[1] 宋为群[1] 王宁[1] 纪媛媛 单桂香 俞洁[1] 王娜[1] 赵朋朋 LI Man;ZHANG Naqin;WANG Jun;SONG Weiqun;WANG Ning;JI Yuanyuan;SHAN Guixiang;YU Jie;WANG Na;ZHAO Pengpeng(Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院,北京100053

出　　处：《中国实用神经疾病杂志》2025年第1期88-93,共6页Chinese Journal of Practical Nervous Diseases

基　　金：首都医科大学宣武医院院级课题(编号:HLZD2020005)。

摘　　要：目的构建神经外科重症患者四级康复护理活动方案并评价其应用效果。方法选取2020-08—12北京市某三级甲等医院神经外科ICU收治的96例患者为试验组,患者入住ICU≥24 h且病情稳定后,根据其意识和肌力评估情况,实施四级康复护理活动方案。选取2020-03—07神经外科ICU收治的99例患者为对照组,给予常规康复护理。比较2组患者的康复状况及并发症发生情况。结果试验组机械通气时间[11(5,17)d比16(7,24)d]、ICU住院时间[13(7,25)d比20(12,30)d]、住院费用[137070(76603,219237)元比193839(129781,321362)元]和出ICU的APACHE-Ⅱ评分[(22.03±7.54)分比(25.21±6.51)分]均低于对照组(P<0.05),出院ADL评分[5(0,15)分比0(0,10)分]高于对照组(P<0.05)。在肺部感染[40(41.67%)比57(57.57%)]和下肢深静脉血栓[3(3.13%)比25(25.25%)]方面,试验组均低于对照组,差异有统计学意义(P<0.05);在ICU谵妄和压力性损伤方面,2组差异无统计学意义(P>0.05)。结论对神经外科重症患者实施四级康复护理活动方案能够改善重症患者的恢复状况,减少并发症的发生,有助于促进重症患者早期康复。Objective To construct a four-level rehabilitation nursing program for severe neurosurgery patients and evaluate its application effect.Methods A total of 96 patients admitted to ICU of Neurosurgery Department of a ClassⅢGrade A Hospital in Beijing from August to December 2020 were selected as the experimental group.After the patient was admitted to ICU for≥24 h and the condition was stable,the four-level rehabilitation nursing activity program was implemented according to the consciousness and muscle strength assessment of the patient.A total of 99 patients admitted to ICU of Neurosurgery Department from March to July 2020 were selected as the control group,and received routine rehabilitation nursing.The recovery status and complications of the two groups were compared.Results The duration of mechanical ventilation(11(5,17)d vs 16(7,24)d),length of stay in ICU(11(5,17)d vs 16(7,24)d),hospitalization cost(137070(76603,219237)yuan vs 193839(129781,321362)yuan)and APACHE-Ⅱscore of exit ICU((22.03±7.54)points vs(25.21±6.51)points)in experimental group were lower than those in control group(P<0.05),and ADL score of discharge(5(0,15)points vs 0(0,10)points)was higher than that in control group(P<0.05).There were statistically significant differences between the two groups in pulmonary infection(40(41.67%)vs 57(57.57%))and lower limb deep vein thrombosis(3(3.13%)vs 25(25.25%),P<0.05),but no significant differences in ICU delirium and stress injury(P>0.05).Conclusion Four-level rehabilitation nursing program for severe neurosurgery patients can improve the recovery of severe patients,reduce the incidence of complications,and contribute to the early recovery of severe patients.

关 键 词：神经外科 重症患者 四级康复 神经重症康复 康复护理 并发症 

分 类 号：R473.74[医药卫生—护理学]