摘要
目的探讨急诊快捷流程在老年急性脑出血救治中的应用效果。方法收集2014年1月~2015年2月四川省内江市第二人民医院急诊科收治的90例老年急性脑出血患者临床资料,依据急诊流程不同进行临床分组,对照组40例采用常规急诊救治流程,观察组50例采用急诊快捷救治流程。观察两组患者接诊到确诊时间、急救实施时间、术前准备时间,急救前后GCS评分、NIHSS评分,急救后日常生活能力评价情况,手术并发症情况。结果观察组患者接诊到确诊时间[(19.6±4.6)min]、急救实施时间[(12.8±2.8)min]、术前准备时间[(26.4±5.1)min]均短于对照组[(27.5±5.6)、(17.8±4.0)、(31.8±6.0)min],差异均有统计学意义(P<0.05)。观察组和对照组急救前GCS[(7.7±1.2)比(7.6±1.1)分]、NIHSS评分[(33.9±5.6)比(33.7±5.2)分]差异均无统计学意义(P>0.05),急救后对照组和观察组GCS[(10.0±1.4)、(12.7±1.5)分]、NIHSS评分[(23.8±3.3)、(16.3±3.0)分]均优于急救前(P<0.05),且观察组患者急救后GCS、NIHSS评分均优于对照组(P<0.05)。急救后观察组患者日常生活能力评价优于对照组,差异有统计学意义(P<0.05)。观察组患者手术并发症发生率(4%)低于对照组(25%),差异有统计学意义(P<0.05)。结论在老年急性脑出血救治中应用急诊快捷流程可以提高抢救效率,改善患者预后水平,降低并发症发生率,值得临床推广应用。
Objective To discuss the application effect of emergency quick process in the treatment of elderly acute cerebral hemorrhage. Methods Clinical data of 90 elder patients with acute cerebral hemorrhage treated in Department of Emergency, Neijiang No.2 People's Hospital of Sichuan Province from January 2014 to February 2015 were collected. According to the emergency process, patients were divided into the contol gorup(n=40) and the observation group(n=50). Patients in the control gorup were given conventional emergency treatment process, while patients in the observation group were given emergency quick process. The accepts time to diagnosis time, first aid implementation time,preoperative preparation time, GCS score and NIHSS score before and after first-aid, activity of daily living evaluation after first-aid, and operative complications in the two groups were observed. Results The accepts time to diagnosis time[(19.6±4.6) min], first aid implementation time [(12.8±2.8) min], preoperative preparation time [(26.4±5.1) min] of the observation group were lower than those of the control group [(27.5 ±5.6),(17.8 ±4.0),(31.8 ±6.0) min], the differences were statistical significance(P < 0.05). The GCS score [(7.7±1.2) vs(7.6±1.1) scores] and NIHSS score [(33.9 ±5.6) vs(33.7±5.2) scores] of the observation group and the control group before first-aid were not statistically significant differences(P > 0.05), the GCS score [(10.0±1.4) vs(12.7±1.5) scores] and NIHSS score [(23.8±3.3) vs(16.3±3.0) scores] of the observation group and the control group after first-aid were all better than before first-aid, and the GCS score and NIHSS score of the observation group after first-aid were better than those of the control group, with statistically significant differences(P < 0.05). The activity of daily living evaluation of the observation group after first-aid was better than that of the control group, with statistically significant difference(P < 0.05). The incidenct of operative complication of the observation group(4%) was lower than that of the control group(25%), with statistically significant difference(P < 0.05). Conclusion Application of emergency quick process in the treatment of elderly acute cerebral hemorrhage can enhance the rescue efficiency, improve prognostic level, reduce incidence of complications, which isv worthy of clinical application.
引文
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