中重型颅脑损伤置管患者居家康复中导管跟踪随访的研究

目的:探讨中重型颅脑损伤置管患者居家康复中导管跟踪随访的效果和对颅脑损伤患者的生活质量的影响。方法 :选择神经外科病房47例符合条件的颅脑损伤置管患者作为研究对象,观察组24例,对照组23例,观察组采用导管跟踪卡+3人成组互推随访模式。对照组进行康复护理指导,常规出院宣教和一般家庭随访、门诊复查。两组患者于出院后3个月、6个月、12个月时进行日常生活能力(ADL)和生活满意度评定,并观察患者并发症和置管意外的发生情况。结果 :出院后3个月时观察组较对照组并发症发生率和意外情况发生率低,且差异有统计学意义(P<0.05),6个月、12个月时观察组生活满意度指标高于对照组,且差异有统计学意义(P<0.05);12个月时观察组ADL评定指标优于对照组,且差异有统计学意义(P<0.05)。结论:施行导管跟踪随访对改善颅脑损伤置管患者的机能状态和日常生活能力、降低患者并发症和意外情况的发生率等方面有积极促进的作用,同时可以减轻家属的经济负担,节约医疗服务资源,为今后神经外科颅脑损伤置管患者家庭护理管理服务提供目标和方向。

Implementing home based tube tracking model to follow up patients in rehabilitation stage after severe brain injury

Objective： To explore the effects of home based tube tracking model to follow up patients after severe brain injury.Methods： A total of 47 severe brain injury patients with tube（s） when discharged from hospital were selected in this study,23 cases in control group and 24 in experimental group.Tube tracking card was used in managing experimental group.Primary nurse,community coordinator,and family member worked as a group to follow up patients.Patients in control group got traditional clinic service and education.Activity of Daily Living（ADL） and life satisfaction level were evaluated at 3,6 and 12 months after discharged.Results： The incidences of complications and accidents were higher in control group after 3 months（P0.05）.Life satisfaction level was higher in experimental group after 6 and 12 months（P0.05）.ADL was also different between them（P0.05） at the end of follow up.Conclusion： Tube tacking model was effective to decrease complications and improve ADL level of patients after severe brain injury.It also could save medical resources and reduce economic burden of family.