目的 研究制订卒中相关肺炎(stroke-associated pneumonia, SAP)防控工作流程,并通过临床实施检查其实用性和有效性。方法 把制订出的SAP防控流程应用于普通卒中病房。采用随机分组,将480例急性卒中患者分为流程组和对照组,每组各240例。流程组按照SAP四步防控流程开展工作,对照组采用神经内科常规医疗护理模式开展工作,对比两组住院期间SAP的发病率、平均住院时间和住院费用。结果 流程组住院期间SAP发病率(7.1%)明显低于对照组(12.9%),两组对比差异有统计学意义(P<0.05)。流程组住院时间(11.4±3.2)d和费用(7343.5±738.1)元均明显低于对照组,差异有统计学意义(P<0.05)。结论 按照SAP的防控流程管理卒中病房,可有效降低SAP的发生,并缩短住院时间,降低住院费用。
Abstract
Objective To constitute the work flow responding to stroke-associated pneumonia(SAP) and determine the effects on the prevention and treatment of SAP. Methods We designed a work flow responding to SAP and observed the effectiveness of the flow in the stroke unit. 480 acute stroke patients were divided into two groups by randomized control trial. The work flow group was treated with four-step procedure interventions, while the control group was given the conventional treatment and nursing measures. The incidence of SAP, the hospitalization duration and expenses between the two groups were compared. Results Seventeen patients suffered from SAP in the work flow group and 31 patients in the control group.The incidence of SAP, the hospitalization duration and expenses in the work flow group were lower than in the control group, the difference between the two groups was statistically significant (P<0.05). Conclusions Using work flow can not only effectively prevent stroke-associated pneumonia but also shorten the length of hospital stay as well as hospitalization expenses.
关键词
脑卒中 /
肺炎 /
工作流程
Key words
stroke /
pneumonia /
work flow
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 孙伟平,黄一宁,王 峥,等.标准吞咽功能评估在卒中后误吸筛查中的应用价值[J]. 中国康复理论与实践,2009,15(4):345-347.
[2] 中华医学会肠外肠内营养学分会神经疾病营养支持学组. 神经系统疾病肠内营养支持操作规范共识(2011版)[J]. 中华神经科杂志,2011,44(11):787-791.
[3] 夏 萍,史俏蓉,霍永忠,等. 欧洲营养风险筛查方法NRS-2002简介及应用现状[J]. 现代预防医学,2007,34(15):2860-2866.
[4] Cuesy P G, Sotomayor P L, Pina J O. Reduction in the incidence of poststroke nosocomial pneumonia by using the “turn-mob”program[J]. J Stroke Cerebrovasc Dis, 2010, 19(1): 23-28.
[5] 卒中相关肺炎诊治专家共识组.卒中相关肺炎诊治中国专家共识[J]. 中华内科杂志, 2010, 49(12): 1075-1078.
[6] Katzan I L, Cebul R D, Husak S H, et al. The effect of pneumonia on mortality among patients hospitalized for acute stroke[J], Neurology, 2003,60:620-625.
[7] Katzan I L, Dawson N V, Thomas C L, et al. The cost of pneumonia after acute stroke[J]. Neurology,2007,68:1938-1943.
[8] 纪风兵,卓 超. 卒中相关肺炎的研究进展[J]. 广东医学,2012,33(7):1029-1031.
[9] 张道培,闫福岭. 卒中相关肺炎及其发病机制[J]. 国际脑血管病杂志,2007,15(1):62-66.
[10] 陈燕婷,徐 运. 卒中诱导的免疫变化及相应治疗策略[J]. 国际脑血管病杂志,2009,17(6):440-443.
[11] Hinchey J A, Shephard T, Furie K, et al. Formal dysphagia screening protocols prevent pneumonia[J]. Stroke, 2005, 36: 1972-1976.
PDF(636 KB)
