BACKGROUND Patients in neurology intensive care units(ICU)are prone to pressure injuries(PU)due to factors such as severe illness,long-term bed rest,and physiological dysfunction.PU not only causes pain and complicati...BACKGROUND Patients in neurology intensive care units(ICU)are prone to pressure injuries(PU)due to factors such as severe illness,long-term bed rest,and physiological dysfunction.PU not only causes pain and complications to patients,but also increases medical burden,prolongs hospitalization time,and affects the recovery process.AIM To evaluate and optimize the effectiveness of pressure injury prevention nursing measures in neurology ICU patients.METHODS A retrospective study was conducted,and 60 patients who were admitted to the ICU of the Department of Neurology were selected and divided into an observation group and a control group according to the order of admission,with 30 people in each group.The observation group implemented pressure injury prevention and nursing measures,while the control group adopted routine care.RESULTS Comparison between observation and control groups following pressure injury prevention nursing intervention revealed significantly lower incidence rates in the observation group compared to the control group at 48 h(8.3%vs 26.7%),7 d(16.7%vs 43.3%),and 14 d(20.0%vs 50.0%).This suggests a substantial reduction in pressure injury incidence in the observation group,with the gap widening over time.Additionally,patients in the observation group exhibited quicker recovery,with a shorter average time to get out of bed(48 h vs 72 h)and a shorter average length of stay(12 d vs 15 d)compared to the control group.Furthermore,post-intervention,patients in the observation group reported significantly improved quality of life scores,including higher scores in body satisfaction,feeling and function,and comfort(both psychological and physiological),indicating enhanced overall well-being and comfort following the implementation of pressure injury prevention nursing measures.CONCLUSION Implementing pressure injury preventive care measures for neurology ICU patients will have better results.展开更多
BACKGROUND:To evaluate the accuracy of National Early Warning Score(NEWS)in predicting clinical outcomes(28-day mortality,intensive care unit[ICU]admission,and mechanical ventilation use)for septic patients with commu...BACKGROUND:To evaluate the accuracy of National Early Warning Score(NEWS)in predicting clinical outcomes(28-day mortality,intensive care unit[ICU]admission,and mechanical ventilation use)for septic patients with community-acquired pneumonia(CAP)compared with other commonly used severity scores(CURB65,Pneumonia Severity Index[PSI],Sequential Organ Failure Assessment[SOFA],quick SOFA[qSOFA],and Mortality in Emergency Department Sepsis[MEDS])and admission lactate level.METHODS:Adult patients diagnosed with CAP admitted between January 2017 and May 2019 with admission SOFA≥2 from baseline were enrolled.Demographic characteristics were collected.The primary outcome was the 28-day mortality after admission,and the secondary outcome included ICU admission and mechanical ventilation use.Outcome prediction value of parameters above was compared using receiver operating characteristics(ROC)curves.Cox regression analyses were carried out to determine the risk factors for the 28-day mortality.Kaplan-Meier survival curves were plotted and compared using optimal cut-off values of qSOFA and NEWS.RESULTS:Among the 340 enrolled patients,90 patients were dead after a 28-day follow-up,62 patients were admitted to ICU,and 84 patients underwent mechanical ventilation.Among single predictors,NEWS achieved the largest area under the receiver operating characteristic(AUROC)curve in predicting the 28-day mortality(0.861),ICU admission(0.895),and use of mechanical ventilation(0.873).NEWS+lactate,similar to MEDS+lactate,outperformed other combinations of severity score and admission lactate in predicting the 28-day mortality(AUROC 0.866)and ICU admission(AUROC 0.905),while NEWS+lactate did not outperform other combinations in predicting mechanical ventilation(AUROC 0.886).Admission lactate only improved the predicting performance of CURB65 and qSOFA in predicting the 28-day mortality and ICU admission.CONCLUSIONS:NEWS could be a valuable predictor in septic patients with CAP in emergency departments.Admission lactate did not predict well the outcomes or improve the severity scores.A qSOFA≥2 and a NEWS≥9 were strongly associated with the 28-day mortality,ICU admission,and mechanical ventilation of septic patients with CAP in the emergency departments.展开更多
目的 探讨三级谵妄护理管理流程在神经内科重症监护室(neurology intensive care unit,NICU)急性脑卒中患者中的应用效果。方法 选择2021年5月至9月本院NICU收治的50例急性脑卒中患者作为研究对象并设为对照组,采取NICU预防谵妄的常规...目的 探讨三级谵妄护理管理流程在神经内科重症监护室(neurology intensive care unit,NICU)急性脑卒中患者中的应用效果。方法 选择2021年5月至9月本院NICU收治的50例急性脑卒中患者作为研究对象并设为对照组,采取NICU预防谵妄的常规护理措施;选择2021年12月至2022年4月收治NICU的50例急性脑卒中患者作为研究对象并设为试验组,试验组患者在对照组基础上实施三级谵妄护理管理流程,比较两组患者ICU谵妄(delirium in the intensive care unit,DICU)发生率、DICU持续时间、NICU住院时间、谵妄相关不良事件发生率;比较干预前后两组患者的谵妄水平和认知功能改善情况。结果 试验组患者DICU发生率较对照组低,两组比较,差异具有统计学意义(P<0.05)。试验组患者DICU持续时间、NICU住院时间较对照组短,谵妄相关不良事件发生率较对照组低;干预后试验组患者重症监护谵妄筛查量表(intensive care delirium screening checklist,ICDSC)评分低于对照组;试验组患者认知功能评分干预前后差值高于对照组,两组比较,差异有统计学意义(均P<0.05)。结论 在NICU急性脑卒中患者中实施三级谵妄护理管理流程可减少患者谵妄的发生,改善患者认知功能,缩短NICU住院时间,降低护理安全风险。展开更多
目的探究重症监护室(Intensive Care Unit,ICU)脑出血术后应用亚低温治疗的临床效果。方法方便选择2020年1月—2023年12月福建医科大学附属三明市第一医院脑出血术后患者152例为研究对象,依据奇偶数法分为两组,各76例。对照组术后予以...目的探究重症监护室(Intensive Care Unit,ICU)脑出血术后应用亚低温治疗的临床效果。方法方便选择2020年1月—2023年12月福建医科大学附属三明市第一医院脑出血术后患者152例为研究对象,依据奇偶数法分为两组,各76例。对照组术后予以常规治疗、研究组术后予以常规治疗+亚低温治疗。比较两组治疗效果、并发症、神经功能、炎症因子、血清指标、活动能力。结果研究组治疗有效率为97.37%,高于对照组的86.84%,差异有统计学意义(χ^(2)=5.790,P=0.016)。研究组并发症总发生率为3.95%,对照组为2.63%,两组比较,差异无统计学意义(P>0.05)。治疗后,研究组神经功能优于对照组,差异有统计学意义(P<0.05)。治疗后,研究组C反应蛋白、白细胞介素-6水平均低于对照组,差异有统计学意义(P均<0.05)。治疗后,研究组血管升压素及内皮素均低于对照组,差异有统计学意义(P均<0.05)。治疗后,研究组上肢、下肢活动能力均优于对照组,差异有统计学意义(P均<0.05)。结论亚低温治疗在ICU脑出血术后治疗中应用效果显著。展开更多
文摘BACKGROUND Patients in neurology intensive care units(ICU)are prone to pressure injuries(PU)due to factors such as severe illness,long-term bed rest,and physiological dysfunction.PU not only causes pain and complications to patients,but also increases medical burden,prolongs hospitalization time,and affects the recovery process.AIM To evaluate and optimize the effectiveness of pressure injury prevention nursing measures in neurology ICU patients.METHODS A retrospective study was conducted,and 60 patients who were admitted to the ICU of the Department of Neurology were selected and divided into an observation group and a control group according to the order of admission,with 30 people in each group.The observation group implemented pressure injury prevention and nursing measures,while the control group adopted routine care.RESULTS Comparison between observation and control groups following pressure injury prevention nursing intervention revealed significantly lower incidence rates in the observation group compared to the control group at 48 h(8.3%vs 26.7%),7 d(16.7%vs 43.3%),and 14 d(20.0%vs 50.0%).This suggests a substantial reduction in pressure injury incidence in the observation group,with the gap widening over time.Additionally,patients in the observation group exhibited quicker recovery,with a shorter average time to get out of bed(48 h vs 72 h)and a shorter average length of stay(12 d vs 15 d)compared to the control group.Furthermore,post-intervention,patients in the observation group reported significantly improved quality of life scores,including higher scores in body satisfaction,feeling and function,and comfort(both psychological and physiological),indicating enhanced overall well-being and comfort following the implementation of pressure injury prevention nursing measures.CONCLUSION Implementing pressure injury preventive care measures for neurology ICU patients will have better results.
基金Capital Clinical Characteristic Application Research of Beijing Municipal Science & Technology Commission (Z171100001017057).
文摘BACKGROUND:To evaluate the accuracy of National Early Warning Score(NEWS)in predicting clinical outcomes(28-day mortality,intensive care unit[ICU]admission,and mechanical ventilation use)for septic patients with community-acquired pneumonia(CAP)compared with other commonly used severity scores(CURB65,Pneumonia Severity Index[PSI],Sequential Organ Failure Assessment[SOFA],quick SOFA[qSOFA],and Mortality in Emergency Department Sepsis[MEDS])and admission lactate level.METHODS:Adult patients diagnosed with CAP admitted between January 2017 and May 2019 with admission SOFA≥2 from baseline were enrolled.Demographic characteristics were collected.The primary outcome was the 28-day mortality after admission,and the secondary outcome included ICU admission and mechanical ventilation use.Outcome prediction value of parameters above was compared using receiver operating characteristics(ROC)curves.Cox regression analyses were carried out to determine the risk factors for the 28-day mortality.Kaplan-Meier survival curves were plotted and compared using optimal cut-off values of qSOFA and NEWS.RESULTS:Among the 340 enrolled patients,90 patients were dead after a 28-day follow-up,62 patients were admitted to ICU,and 84 patients underwent mechanical ventilation.Among single predictors,NEWS achieved the largest area under the receiver operating characteristic(AUROC)curve in predicting the 28-day mortality(0.861),ICU admission(0.895),and use of mechanical ventilation(0.873).NEWS+lactate,similar to MEDS+lactate,outperformed other combinations of severity score and admission lactate in predicting the 28-day mortality(AUROC 0.866)and ICU admission(AUROC 0.905),while NEWS+lactate did not outperform other combinations in predicting mechanical ventilation(AUROC 0.886).Admission lactate only improved the predicting performance of CURB65 and qSOFA in predicting the 28-day mortality and ICU admission.CONCLUSIONS:NEWS could be a valuable predictor in septic patients with CAP in emergency departments.Admission lactate did not predict well the outcomes or improve the severity scores.A qSOFA≥2 and a NEWS≥9 were strongly associated with the 28-day mortality,ICU admission,and mechanical ventilation of septic patients with CAP in the emergency departments.
文摘目的 探讨三级谵妄护理管理流程在神经内科重症监护室(neurology intensive care unit,NICU)急性脑卒中患者中的应用效果。方法 选择2021年5月至9月本院NICU收治的50例急性脑卒中患者作为研究对象并设为对照组,采取NICU预防谵妄的常规护理措施;选择2021年12月至2022年4月收治NICU的50例急性脑卒中患者作为研究对象并设为试验组,试验组患者在对照组基础上实施三级谵妄护理管理流程,比较两组患者ICU谵妄(delirium in the intensive care unit,DICU)发生率、DICU持续时间、NICU住院时间、谵妄相关不良事件发生率;比较干预前后两组患者的谵妄水平和认知功能改善情况。结果 试验组患者DICU发生率较对照组低,两组比较,差异具有统计学意义(P<0.05)。试验组患者DICU持续时间、NICU住院时间较对照组短,谵妄相关不良事件发生率较对照组低;干预后试验组患者重症监护谵妄筛查量表(intensive care delirium screening checklist,ICDSC)评分低于对照组;试验组患者认知功能评分干预前后差值高于对照组,两组比较,差异有统计学意义(均P<0.05)。结论 在NICU急性脑卒中患者中实施三级谵妄护理管理流程可减少患者谵妄的发生,改善患者认知功能,缩短NICU住院时间,降低护理安全风险。
文摘目的探究重症监护室(Intensive Care Unit,ICU)脑出血术后应用亚低温治疗的临床效果。方法方便选择2020年1月—2023年12月福建医科大学附属三明市第一医院脑出血术后患者152例为研究对象,依据奇偶数法分为两组,各76例。对照组术后予以常规治疗、研究组术后予以常规治疗+亚低温治疗。比较两组治疗效果、并发症、神经功能、炎症因子、血清指标、活动能力。结果研究组治疗有效率为97.37%,高于对照组的86.84%,差异有统计学意义(χ^(2)=5.790,P=0.016)。研究组并发症总发生率为3.95%,对照组为2.63%,两组比较,差异无统计学意义(P>0.05)。治疗后,研究组神经功能优于对照组,差异有统计学意义(P<0.05)。治疗后,研究组C反应蛋白、白细胞介素-6水平均低于对照组,差异有统计学意义(P均<0.05)。治疗后,研究组血管升压素及内皮素均低于对照组,差异有统计学意义(P均<0.05)。治疗后,研究组上肢、下肢活动能力均优于对照组,差异有统计学意义(P均<0.05)。结论亚低温治疗在ICU脑出血术后治疗中应用效果显著。
