Department of Respiratory and Critical Care Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, No. 7 of Weiwu Road, Jinshui District, Zhengzhou, 450003, Henan, China.
BMC Pulm Med. 2020 Mar 5;20(1):61. doi: 10.1186/s12890-020-1100-7.
This study aimed to explore the feasibility of applying the respiratory "critical care-sub-critical care-rehabilitation integrated management model" in severe stroke-associated pneumonia and evaluate its effect.
From January to September 2018, 24 patients with severe stroke-associated pneumonia, who were admitted to the Respiratory Intensive Care Unit of the Respiratory and Critical Care Medicine Department of Henan Provincial People's Hospital, were randomly divided into two groups: integrated management group and control group. According to the admission criteria of the respiratory "critical care-sub-critical care-rehabilitation integrated model" prescribed by the above-mentioned hospital, patients were grouped. The professional respiratory therapy team participated in the whole treatment. The acute physiology and chronic health evaluation II (APACHE II) score, clinical pulmonary infection score (CPIS) and oxygenation index of these two groups were dynamically observed, and the average hospital stay, 28-day mortality and patient satisfaction were investigated.
Patients in the integrated management group and control group were similar before treatment (P > 0.05). After treatment, the main indicators, the APACHE II score, CPIS score and oxygenation index, were significantly different between the integration group and control group (P < 0.05). The secondary indicators, the average hospitalization days and patient/family member satisfaction scores, were also significantly different between the integration group and control group (P < 0.05). However, the 28-day mortality wasn't significantly different (P > 0.05).
For patients with severe stroke-associated pneumonia, it was feasible to implement the respiratory "critical care-sub-critical care-rehabilitation integrated management model", which could significantly improve the treatment effect, shorten average hospitalization days and improve patient/family satisfaction.
本研究旨在探讨将呼吸“危重症-亚重症-康复一体化管理模式”应用于重症脑卒中相关性肺炎的可行性，并评价其效果。
2018 年 1 月至 9 月，将河南省人民医院呼吸与危重症医学科呼吸重症监护病房收治的 24 例重症脑卒中相关性肺炎患者随机分为两组：综合管理组和对照组。根据该院制定的呼吸“危重症-亚重症-康复一体化管理模式”的入院标准进行分组，由专业的呼吸治疗团队参与全程治疗。动态观察两组患者的急性生理学与慢性健康状况评分系统Ⅱ（APACHE Ⅱ）评分、临床肺部感染评分（CPIS）和氧合指数，并调查两组患者的平均住院时间、28 天病死率和患者满意度。
综合管理组和对照组患者治疗前一般资料比较差异无统计学意义（P>0.05）。治疗后，综合管理组的 APACHE Ⅱ评分、CPIS 评分和氧合指数与对照组比较，差异均有统计学意义（P<0.05）。次要指标中，综合管理组的平均住院时间和患者/家属满意度评分与对照组比较，差异均有统计学意义（P<0.05）。但 28 天病死率比较差异无统计学意义（P>0.05）。
对重症脑卒中相关性肺炎患者实施呼吸“危重症-亚重症-康复一体化管理模式”是可行的，可显著提高治疗效果，缩短平均住院时间，提高患者/家属满意度。
