摘要
目的探讨快速康复外科(FTS)措施在脑出血手术患者中的应用效果。方法收集2019年1月至2021年12月于安徽省皖南康复医院/芜湖市第五人民医院接受手术治疗的脑出血患者的临床资料,根据围手术期干预措施的不同将其分为常规组(采用常规干预措施)和FTS组(采用FTS措施),每组39例。比较两组患者出院前的康复进程指标,包括术后尿管留置时间、肠鸣音恢复时间、排便时间、下床活动时间、住院时间。比较两组患者干预前后血肿量、水肿量、神经功能缺损情况[美国国立卫生研究院卒中量表(NIHSS)评分]。比较两组患者干预前后的凝血功能指标,包括D-二聚体(D-D)、纤维蛋白原(FIB)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)。比较两组患者干预前后的日常生活能力(ADL)、运动功能(Fugl-Meye量表评分)及出院前下肢深静脉血栓(DVT)及术后不良事件的发生情况。结果FTS组患者的术后尿管留置时间、肠鸣音恢复时间、排便时间、下床活动时间、住院时间均明显短于常规组患者,差异均有统计学意义(P<0.01)。干预后,FTS组患者的血肿量、水肿量、NIHSS评分均低于常规组患者,差异均有统计学意义(P<0.05)。干预后,FTS组患者的D-D、FIB水平均低于常规组患者,PT、APTT均长于常规组患者,ADL、Fugl-Meye量表评分均高于常规组患者,差异均有统计学意义(P<0.05)。FTS组患者术后下肢DVT、压疮的发生率均低于常规组患者,差异均有统计学意义(P<0.05)。结论FTS措施能够有效改善脑出血患者的凝血功能,改善术后神经功能、运动功能和ADL,促进患者术后恢复,降低术后不良事件的发生风险。
Objective To investigate the application effect of fast track surgery(FTS)measures in patients with cerebral hemorrhage surgery.Method The clinical data of patients with cerebral hemorrhage who received surgical treatment in Anhui Wannan Rehabilitation Hospital/Wuhu Fifth People's Hospital from January 2019 to December 2021 were collected,and according to the different perioperative intervention measures,they were divided into routine group(using conventional interventions)and FTS group(using FTS measures)with 39 cases in each group.The indicators of rehabilitation progress before discharge including postoperative urinary catheter indwelling time,bowel sound recovery time,defecation time,ambulation time,and hospital stay were compared between the two groups of patients.The hematoma volume,edema volume,and neurological deficit[National Institutes of Health stroke scale(NIHSS)score]were compared between the two groups before and after the intervention.The coagulation function indexes of the two groups before and after intervention were compared,including D-dimer(D-D),fibrinogen(FIB),prothrombin time(PT),and activated partial thromboplastin time(APTT).The activities of daily living(ADL),motor function(the scores of Fugl-Meye scale),lower extremity deep vein thrombosis(DVT)before discharge,and postoperative adverse events were compared between the two groups before and after the intervention.Result The postoperative urinary catheter indwelling time,bowel sound recovery time,defecation time,ambulation time,and hospitalization time in the FTS group were significantly shorter than those in the routine group,and the differences were statistically significant(P<0.01).After the intervention,the hematoma volume,edema volume,and NIHSS score in the FTS group were lower than those in the routine group,and the differences were statistically significant(P<0.05).After the intervention,the levels of D-D and FIB in the FTS group were lower than those in the routine group,the PT and APTT were longer than those in the routine group,t
作者
周娟娟
胡刚
张凤芳
李卫东
Zhou Juanjuan;Hu Gang;Zhang Fengfang;Li Weidong(Department of Neurosurgery,Anhui Wannan Rehabilitation Hospital/the Fifth People's Hospital of Wuhu,Wuhu 241000,Anhui,China;Department of Neurosurgery,Wuhu No.1 People's Hospital,Wuhu 241000,Anhui,China)
出处
《血管与腔内血管外科杂志》
2022年第6期729-733,748,共6页
Journal of Vascular and Endovascular Surgery
关键词
快速康复外科
脑出血
手术
凝血功能
神经功能
深静脉血栓
fast track surgery
cerebral hemorrhage
surgery
coagulation function
neurological function
deep vein thrombosis
