基于延续性护理的神经外科重型颅脑损伤患者的生存分析

Survival analysis of patients with severe craniocerebral injury in neurosurgery department based on continuing nursing

目的：探讨延续性护理对神经外科重型颅脑损伤患者康复效果的生存状况影响。方法选择2008年1月—2009年12月南京医科大学附属淮安第一医院神经外科出院的重型颅脑损伤患者303例，根据随机数字表法分为对照组（140例）和干预组（163例），对照组患者出院后1周予以电话回访1次，之后嘱患者有情况随时电话咨询或来院复诊，不再主动回访；干预组患者予以电话跟踪回访、建立延续性护理微信群、家庭访视、成立脑友俱乐部等方式提供延续性护理干预，自患者出院1周起回访至患者死亡或2015年12月。采用生存分析评价两组患者的生存率。结果通过Kaplan-Meier法计算得出干预组及对照组患者的生存率分别为78.8％和62.3％，干预组的生存率高于对照组，差异有统计学意义（χ2=33.91，P＜0.05）。结论随着时间的推移实施延续性护理有助于提高重型颅脑损伤患者的生存状况。

ObjectiveTo discuss the effects of continuing nursing on the living condition of patients with severe craniocerebral injury in neurosurgery department.Methods A total of 303 patients with severe craniocerebral injury from January 2008 to December 2009 in neurosurgery department of Huai＆#39;an First People＆#39;s Hospital,Nanjing Medical University were randomly divided into the control group （140 cases） and the intervention group （163 cases）. Patients in the control group were followed up once by the phone at the first week after discharge. There was no longer follow-up after the first week and patients could call or visit hospital in case of problems. Patients in the intervention group received continuing nursing intervention by telephone follow-up visit,the establishment of continuing nursing WeChat group,family visit and the establishment of brain club. Patients were followed up from the first week after discharge until the death of patients or December 2015. Survival rate of two groups was evaluated by survival analysis.Results The survival rate of patients in the intervention group and the control group were 78.8% and 62.3%,which were calculated by the Kaplan-Meier method. The survival rate of patients in the intervention group was significantly higher than that in the control group （χ2=33.91,P〈0.05）.Conclusions Continuing nursing helps to improve the survival situation of patients with severe craniocerebral injury in the process of time.