神经内外科整合在卒中单元救治中的效果和优越性研究

The merits of consolidated department of internal and surgical neurology in a stroke unit

目的探讨神经内外科整合在卒中单元救治中的优越性,并观察组织化卒中医疗模式治疗出血性脑卒中的近期效果。方法将神经内科、神经外科整合为一个一级临床科室—脑系科,建立完善的多学科一体化治疗的组织化卒中医疗网络体系。将符合标准的81例出血性脑卒中患者随机分为组织化卒中医疗模式治疗组(A组)及以往常规治疗对照组(B组)进行治疗,比较分析两组临床神经功能缺损程度、日常生活活动能力、意识障碍程度、并发症及近期临床疗效的差异,并对经济社会效益进行分析。结果A组在神经功能缺损程度评分、日常生活活动能力评分、意识障碍程度评分及近期临床疗效方面,均明显优于B组(P均<0.01),并发症的发生率亦显著低于B组(P<0.01),而且A组每提高患者的一个功能单位,所需的费用较B组患者明显减少。结论将神经内科、神经外科整合为一个一级临床科室在卒中单元救治中具有明显的优越性,采用组织化卒中医疗模式治疗出血性脑卒中有确切疗效。

Objective To discuss the advantages of consolidated department of internal and surgical neurology in a stroke unit and investigate the short-term curative effects of organized stroke treatment model of hemorrhagic stroke. Methods The departments of internal and surgical neurology were integrated into a one-level clinical admin- istrative unit--Department of Neurology and Neurosurgery so as to establish a perfect and multi-subjects network of or- ganized stroke treatment model of hemorrhagic stroke. Eighty-one patients who matched with the standard were randomized into two groups ： organized stroke care group （ Group A） and control group （ Group B）. Both groups were compared and analyzed in terms of the degree of nerval disfunction, the ability of daily life and activities, the degree of unconsciousness, the complication and the short-term clinical effects, and the consequent economic and social benefits were also analyzed. Results The evaluations of nerval disfunction, the ability of daily life and activities, the degree of unconsciousness and the short-term clinical effects of group A were apparently better than those of group B （P 〈 0. 01 ）, and the complications of group A less than those of group B （P 〈 0. 01 ）. And also, each increase of a function unit in group A cost less than that of group B. Conclusion Integrating the departments of internal and surgery neurology into a one-level clinical administrative unit has its advantages, and the organized stroke treatment model is effective in treating hemorrhagic stroke.