链式管理对重型颅脑损伤患者抢救时间及术后康复的影响  

Effects of chain management on rescue time and postoperative rehabilitation of patients with severe craniocerebral injury

作　　者：黄可可 徐静[2] 韩雪迎[1] 杨洋[1] 范洁[3] HUANG Keke;XU Jing;HAN Xueying;YANG Yang;FAN Jie(Department of Emergency,Shangqiu First People's Hospital,Shangqiu,Henan 476100,China;Department of Neurosurgery,Shangqiu First People's Hospital,Shangqiu,Henan 476100,China;Department of Neurology,Shangqiu First People's Hospital,Shangqiu,Henan 476100,China)

机构地区：[1]商丘市第一人民医院急诊科,河南商丘476100 [2]商丘市第一人民医院神经外科,河南商丘476100 [3]商丘市第一人民医院神经内科,河南商丘476100

出　　处：《中华神经外科疾病研究杂志》2025年第2期96-100,共5页Chinese Journal of Neurosurgical Disease Research

基　　金：河南省医学科技攻关计划项目(LHGJ20200934)。

摘　　要：目的探讨链式管理对重型颅脑损伤患者抢救时间及术后康复的影响。方法按随机数字表法将2022年1月至2024年2月商丘市第一人民医院收治的220例重型颅脑损伤患者分为对照组与观察组(各110例)。对照组采取传统流程管理进行院前、院内救治,观察组采取链式管理进行院前、院内救治。对比两组患者抢救时间、抢救成功率、术后康复情况、并发症发生率、随访6个月格拉斯哥预后评分(GOS)及家属护理满意度。结果对照组院前急救时间、院内急救时间均高于观察组,对照组抢救成功率低于观察组(P<0.05)。出院时,两组患者临床神经功能缺损评分(CSS)较入院时降低,改良Barthel指数(BI)评分较入院时升高,且出院时观察组患者CSS评分低于对照组,BI评分高于对照组(P均<0.05)。对照组并发症发生率(21.82%)高于观察组(8.18%)(P<0.05)。两组患者随访6个月GOS评分等级比较存在明显差异(P<0.05)。观察组家属总护理满意度(97.27%)高于对照组(86.36%)(P<0.05)。结论链式管理能够缩短重型颅脑损伤患者院内及院外抢救时间,改善患者神经功能、生活质量及预后,且可以减少并发症,促进术后康复,家属护理满意度较高。Objective To explore the effects of chain management on rescue time and postoperative rehabilitation of patients with severe craniocerebral injury.Methods 220 cases with severe craniocerebral injury admitted to Shangqiu First People's Hospital from January 2022 to February 2024 were selected and divided into control group and observation group(110 cases in each group)by random number table method.The control group was given traditional process management for pre-hospital and in-hospital treatment,while the observation group was given chain management for pre-hospital and in-hospital treatment.The rescue time,rescue success rate,postoperative rehabilitation,complications rate,Glasgow prognosis score(GOS)results at 6 months follow-up and family nursing satisfaction of the two groups were compared.Results The pre-hospital first aid time and in-hospital first aid time of the control group were higher than the observation group,and the success rate of rescue of the control group was lower than the observation group(P<0.05).At discharge,the neurological function score measured by the clinical neurological deficit score(CSS)of the two groups was lower than that at admission,and the modified Barthel index(BI)score was higher than that at admission.At discharge,the CSS score of the observation group was lower than the control group,and the BI score was higher than the control group(P<0.05).The incidence of complications in the control group(21.82%)was higher than the observation group(8.18%)(P<0.05).There was significant difference in GOS score between the 2 groups after 6 months of follow-up(P<0.05).The total nursing satisfaction of patients'families in the observation group(97.27%)was higher than the control group(86.36%)(P<0.05).Conclusions Chain management can shorten the rescue time in and out of hospital for patients with severe craniocerebral injury,improve the neurological function,quality of life and prognosis of patients,reduce complications,promote postoperative rehabilitation,and improve the nursing satisfacti

关 键 词：链式管理 重型颅脑损伤 抢救时间 术后康复 

分 类 号：R651.15[医药卫生—外科学]