Zhao Bin, Wang Heng
Department of Taditional Chinese Medicine Rehabilitation, The Third Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China.
Trauma Center, The Third Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China.
Front Surg. 2023 Jan 6;9:1014211. doi: 10.3389/fsurg.2022.1014211. eCollection 2022.
To observe the intervention effect of perioperative rehabilitation intervention of integrated medical care the concept of FTS on stress response and postoperative complications in patients undergoing craniocerebral injury surgery.
70 patients with Traumatic brain injury (TBI) admitted to the Department of Neurosurgery of our Hospital from January 2019 to December 2021 were as the research objects and were divided into general group and FTS group according to the random number table method, with 35 cases in each group. The general group was intervened with perioperative basic nursing measures for TBI, and the FTS group was intervened with perioperative rehabilitation model of integrated medical care under the concept of FTS on the basis of the general group. The two groups of patients were compared in hemodynamic indexes (heart rate, mean arterial pressure), stress hormone levels (CORT, GLU, E), changes in motor neurological function (GCS score, NHISS score, FMA score), occurrence of postoperative complications (infection, pressure sores, rebleeding, central hyperthermia), short-term quality of life (SF-36) before and after the intervention.
After intervention, the levels of HR, MAP, COR, GLU, and E were significantly lower in FTS group than in the general group (all < 0.05). After intervention, the Fugl-Meyer score and Barthel index score of upper and lower extremities in both groups were significantly higher than those before intervention, and the FTS group was higher than the general group, and the difference was statistically significant ( < 0.05). After the intervention, the NIHSS scores were significantly lower in both groups than before the intervention, and the FTS group was lower than the general group, and the differences were statistically significant ( < 0.05). Short-term physical function, somatic pain, physical function, general health status, social function, energy, mental health, and emotional function scores were significantly higher in the FTS group than in thegeneral group, and all differences were statistically significant ( < 0.05). The total incidence of infection, pressure ulcers, rebleeding, central high fever and other complications in the FTS group was significantly lower than that in the general group ( < 0.05).
The implementation of integrated perioperative rehabilitation interventions under the concept of FTS for patients with TBI can significantly alleviate patients' stress, promote recovery, reduce the incidence of complications, and improve short-term quality of life, which is worthy of clinical promotion.
观察围手术期康复干预结合快速康复外科（FTS）理念对颅脑损伤手术患者应激反应及术后并发症的干预效果。
选取2019年1月至2021年12月我院神经外科收治的70例创伤性脑损伤（TBI）患者作为研究对象，采用随机数字表法分为常规组和FTS组，每组35例。常规组采用TBI围手术期基本护理措施进行干预，FTS组在常规组基础上采用FTS理念下的围手术期综合医疗康复模式进行干预。比较两组患者干预前后的血流动力学指标（心率、平均动脉压）、应激激素水平（皮质醇、血糖、肾上腺素）、运动神经功能变化（格拉斯哥昏迷量表评分、美国国立卫生研究院卒中量表评分（NHISS评分）、Fugl-Meyer评估量表评分（FMA评分））、术后并发症发生情况（感染、压疮、再出血、中枢性高热）、短期生活质量（SF-36）。
干预后，FTS组心率、平均动脉压、皮质醇、血糖、肾上腺素水平均显著低于常规组（均P<0.05）。干预后，两组患者上下肢Fugl-Meyer评分及Barthel指数评分均显著高于干预前，且FTS组高于常规组，差异有统计学意义（P<0.05）。干预后，两组患者美国国立卫生研究院卒中量表评分均显著低于干预前，且FTS组低于常规组，差异有统计学意义（P<0.05）。FTS组短期身体功能、躯体疼痛、生理功能、总体健康状况、社会功能、精力、心理健康、情感功能评分均显著高于常规组，差异均有统计学意义（P<0.05）。FTS组感染、压疮、再出血、中枢性高热等并发症总发生率显著低于常规组（P<0.05）。
对TBI患者实施FTS理念下的围手术期综合康复干预，可显著减轻患者应激反应，促进恢复，降低并发症发生率，提高短期生活质量，值得临床推广。
