Su Yingying, Teng Junfang, Tian Fei, Jing Jing, Huang Huijin, Pan Suyue, Jiang Wen, Wang Furong, Zhang Le, Zhang Yan, Zhang Meng, Liu Liping, Cao Jie, Hu Huaiqiang, Li Wei, Liang Cheng, Ma Liansheng, Meng Xuegang, Tian Linyu, Wang Changqing, Wang Lihua, Wang Yan, Wang Zhenhai, Wang Zhiqiang, Xie Zunchun, You Mingyao, Yuan Jun, Zeng Chaosheng, Zeng Li, Zhang Lei, Zhang Xin, Zhang Yongwei, Zhao Bin, Zhou Saijun, Zhou Zhonghe
Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Front Neurol. 2023 Feb 21;14:1114204. doi: 10.3389/fneur.2023.1114204. eCollection 2023.
To understand the varieties, evaluation, treatment, and prognosis of severe neurological diseases using the third NCU survey in China.
A cross-sectional questionnaire study. The study was completed in three main steps: filling in the questionnaire, sorting out the survey data, and analyzing the survey data.
Of 206 NCUs, 165 (80%) provided relatively complete information. It was estimated that 96,201 patients with severe neurological diseases were diagnosed and treated throughout the year, with an average fatality rate of 4.1%. The most prevalent severe neurological disease was cerebrovascular disease (55.2%). The most prevalent comorbidity was hypertension (56.7%). The most prevalent complication was hypoproteinemia (24.2%). The most common nosocomial infection was hospital-acquired pneumonia (10.6%). The GCS, APACHE II, EEG, and TCD were the most commonly used (62.4-95.2%). The implementation rate of the five nursing evaluation techniques reached 55.8-90.9%. Routinely raising the head of the bed by 30°, endotracheal intubation and central venous catheterization were the mostprevalent treatment strategies (97.6, 94.5, and 90.3%, respectively). Traditional tracheotomy, invasive mechanical ventilation and nasogastric tube feeding (75.8, 95.8, and 95.8%, respectively) were more common than percutaneous tracheotomy, non-invasive mechanical ventilation and nasogastric tube insertion (57.6, 57.6, and 66.7%, respectively). Body surface hypothermia brain protection technology was more commonly used than intravascular hypothermia technology (67.3 > 6.1%). The rates of minimally invasive hematoma removal and ventricular puncture were only 40.0 and 45.5%, respectively.
In addition to traditional recognized basic life assessment and support technology, it is necessary to the use of promote specialized technology for neurological diseases, according to the characteristics of critical neurological diseases.
通过第三次中国神经重症监护病房（NCU）调查了解重症神经系统疾病的种类、评估、治疗及预后情况。
横断面问卷调查研究。该研究主要分三个步骤完成：填写问卷、整理调查数据及分析调查数据。
206个NCU中，165个（80%）提供了相对完整的信息。据估计，全年共诊断并治疗96,201例重症神经系统疾病患者，平均死亡率为4.1%。最常见的重症神经系统疾病是脑血管病（55.2%）。最常见的合并症是高血压（56.7%）。最常见的并发症是低蛋白血症（24.2%）。最常见的医院感染是医院获得性肺炎（10.6%）。格拉斯哥昏迷量表（GCS）、急性生理与慢性健康状况评分系统II（APACHE II）、脑电图（EEG）和经颅多普勒超声（TCD）是最常用的（62.4 - 95.2%）。五项护理评估技术的实施率达到55.8 - 90.9%。常规将床头抬高30°、气管插管和中心静脉置管是最常用的治疗策略（分别为97.6%、94.5%和90.3%）。传统气管切开术、有创机械通气和鼻饲（分别为75.8%、95.8%和95.8%）比经皮气管切开术、无创机械通气和鼻肠管置入（分别为57.6%、57.6%和66.7%）更常见。体表亚低温脑保护技术比血管内亚低温技术使用更普遍（67.3% > 6.1%）。微创血肿清除术和脑室穿刺术的使用率分别仅为40.0%和45.5%。
除传统公认的基本生命评估和支持技术外，有必要根据重症神经系统疾病的特点推广使用神经疾病专科技术。
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