神經(jīng)重癥患者的電生理監(jiān)測170張課件

NCCU洞的神經(jīng)能監(jiān)測2019-4-17NCCU洞的神經(jīng)1內(nèi)容提要背景:神經(jīng)CU建立的益處內(nèi)容:神經(jīng)cU的特色·TCD/EEG/SEP/腦死亡評價總結(jié):神經(jīng)?？漆t(yī)師及特殊監(jiān)護手段,將大大提高醫(yī)院的診療水平內(nèi)容提要2組建NCU的目的和意義·NcCU治療疾病-卒中,急性腦脊髓損傷呼衰、心衰并發(fā)癥神外、介入患者術(shù)后監(jiān)護NCCU是多科的協(xié)作神內(nèi)神外麻醉科放射科管理組建NCU的目的和意義3腦出血患者在NCCU的生存率更高2.8°NeuroNCCU的Genera生存率01520253035404550更高圖1.1素積生存由線顯示入住神經(jīng)重走監(jiān)護室的腦內(nèi)出血患者的病死率較低;入住LCU10天后,生存率增加了10%6;引自:DiringerMN,EdwardsoF,AiyagariV,HollingsworthH(2019Factorsassociatedwithwithdrawalofmechanicalventilationinaneurology/neurosurgeryintensivecareunit.CritCareMed29:1792-1797腦出血患者在NCCU的生存率更高4腦出血患者:NCCU&|CUICUFY·9■NSICUFY·9795年I死亡率減低康復率增加60住院時間短40ortalitysHome/RehabLOS(days)圖12入住內(nèi)·外科1CU與入住神經(jīng)科學亞?？艭U(NSCU)的腦內(nèi)出血(ECH)預后數(shù)據(jù)的比較:GCs格拉斯哥昏迷量表評分;Rhab=族復總位時間:SEM=平均值的標準誤:引自:MirskiMA,ChangCw,CowanR(2019]Impactofaneuroscienceintensivecareunitonneurosurgicalpatientoutcomesandcostofcare:evidence-basedsupportforanintensivist-directedspecialtyiCUmodelofcare,INeurosurgAnesthesiol腦出血患者:NCCU&|CU5神外術(shù)后患者:NCCU減少住院日p<.05,5P<.01comparedtobenchmarkNon-NSICU蘭E5Eeeo40顱骨切開術(shù)§顱骨骨折50DRG001ORG002DRG027DRG028圖13數(shù)據(jù)來自于國家數(shù)據(jù)庫[HBSInternationalInc(HBs,bellevue,wl]l圖例顯示了神經(jīng)科學亞?？艭UNSU)和其他病房(非NSu病房包括急性監(jiān)護病房、監(jiān)護病房以及內(nèi)科外科Cu)的住院時間分別與國家標準住院時間的差別(%);A-DRGs001和002=傾骨切開術(shù)合并或不合并腦內(nèi)出血或昏迷:A-DRGs027和Q28=顱骨骨折合并或不合并出血或昏迷:L05=住院時間:DRG=診斷相關(guān)組:SEM=平均值的標準R:SIE:MirskiMA,ChangCW,CowanR(2019)Impactofaneuroscienceintensivecareunitonneurosurgicalpatientoutcomesandcostofcare:evidence-basedsupportforanintensivist-directedspecialtyICUmodelofcare.JNeurosurgAnesthesiol13:83-92神外術(shù)后患者:NCCU減少住院日6神外術(shù)后患者:NCCU減少總花費=2000中第四M84000顱骨切開術(shù)顱骨骨折tSEM.P<.05,sP<.01comparedtobenchmarkDRG002DRG027DRG028表14數(shù)據(jù)來自國家數(shù)據(jù)庫tm時ational,Inc.(HBS,.eden,wl,圖例顯示了神經(jīng)科學亞?？苐CNsCu)和其他病房(非NCU病房包活急性監(jiān)護病房、監(jiān)護病房以及內(nèi)科/外科Cu》每例患者的花費(s)分別與國標準花費的差別(%);ADRG001和002=顱骨切開術(shù)臺并或不合并腦內(nèi)出血或昏迷;A-DRGs027和C2=顱骨骨折合并或不合并出血或昏迷;DRG=診斷相關(guān)組;M=平均值的標準誤;引自;MrsMMA,ChangCW,CowanR(2019)Impactofaneuroscienceintensivecareunitonneurosurgicalpatientoutcomesandcostofcare:evidence-basedsupportforanintenshvist-directedspecialtyCUmodelofcare.JNeurosurg神外術(shù)后患者:NCCU減少總花費7NCCU的醫(yī)師配置主任主治主治住院醫(yī)師住院醫(yī)師住院醫(yī)師住院醫(yī)師NCCU的醫(yī)師配置8NcCU的護士配置護士3班倒護士長主班當班護士當班護士當班護士當班護士當班護輪班護士取藥、送333病人NcCU的護士配置9患者家屬探視醫(yī)生工作理天壇醫(yī)院神內(nèi)監(jiān)護病房平面圖隔離病房隔離病房醫(yī)護及患老患者家屬10神經(jīng)重癥患者的電生理監(jiān)測170張課件11神經(jīng)重癥患者的電生理監(jiān)測170張課件12神經(jīng)重癥患者的電生理監(jiān)測170張課件13神經(jīng)重癥患者的電生理監(jiān)測170張課件14神經(jīng)重癥患者的電生理監(jiān)測170張課件15神經(jīng)重癥患者的電生理監(jiān)測170張課件16神經(jīng)重癥患者的電生理監(jiān)測170張課件17神經(jīng)重癥患者的電生理監(jiān)測170張課件18神經(jīng)重癥患者的電生理監(jiān)測170張課件19神經(jīng)重癥患者的電生理監(jiān)測170張課件20神經(jīng)重癥患者的電生理監(jiān)測170張課件21神經(jīng)重癥患者的電生理監(jiān)測170張課件22神經(jīng)重癥患者的電生理監(jiān)測170張課件23神經(jīng)重癥患者的電生理監(jiān)測170張課件24神經(jīng)重癥患者的電生理監(jiān)測170張課件25神經(jīng)重癥患者的電生理監(jiān)測170張課件26神經(jīng)重癥患者的電生理監(jiān)測170張課件27神經(jīng)重癥患者的電生理監(jiān)測170張課件28神經(jīng)重癥患者的電生理監(jiān)測170張課件29神經(jīng)重癥患者的電生理監(jiān)測170張課件30神經(jīng)重癥患者的電生理監(jiān)測170張課件31神經(jīng)重癥患者的電生理監(jiān)測170張課件32神經(jīng)重癥患者的電生理監(jiān)測170張課件33神經(jīng)重癥患者的電生理監(jiān)測170張課件34神經(jīng)重癥患者的電生理監(jiān)測170張課件35神經(jīng)重癥患者的電生理監(jiān)測170張課件36神經(jīng)重癥患者的電生理監(jiān)測170張課件37神經(jīng)重癥患者的電生理監(jiān)測170張課件38神經(jīng)重癥患者的電生理監(jiān)測170張課件39神經(jīng)重癥患者的電生理監(jiān)測170張課件40神經(jīng)重癥患者的電生理監(jiān)測170張課件41神經(jīng)重癥患者的電生理監(jiān)測170張課件42神經(jīng)重癥患者的電生理監(jiān)測170張課件43神經(jīng)重癥患者的電生理監(jiān)測170張課件44神經(jīng)重癥患者的電生理監(jiān)測170張課件45神經(jīng)重癥患者的電生理監(jiān)測170張課件46神經(jīng)重癥患者的電生理監(jiān)測170張課件47神經(jīng)重癥患者的電生理監(jiān)測170張課件48神經(jīng)重癥患者的電生理監(jiān)測170張課件49神經(jīng)重癥患者的電生理監(jiān)測170張課件50神經(jīng)重癥患者的電生理監(jiān)測170張課件51神經(jīng)重癥患者的電生理監(jiān)測170張課件52神經(jīng)重癥患者的電生理監(jiān)測170張課件53神經(jīng)重癥患者的電生理監(jiān)測170張課件54神經(jīng)重癥患者的電生理監(jiān)測170張課件55神經(jīng)重癥患者的電生理監(jiān)測170張課件56神經(jīng)重癥患者的電生理監(jiān)測170張課件57神經(jīng)重癥患者的電生理監(jiān)測170張課件58神經(jīng)重癥患者的電生理監(jiān)測170張課件59神經(jīng)重癥患者的電生理監(jiān)測170張課件60神經(jīng)重癥患者的電生理監(jiān)測170張課件61神經(jīng)重癥患者的電生理監(jiān)測170張課件62神經(jīng)重癥患者的電生理監(jiān)測170張課件63神經(jīng)重癥患者的電生理監(jiān)測170張課件64神經(jīng)重癥患者的電生理監(jiān)測170張課件65神經(jīng)重癥患者的電生理監(jiān)測170張課件66神經(jīng)重癥患者的電生理監(jiān)測170張課件67神經(jīng)重癥患者的電生理監(jiān)測170張課件68神經(jīng)重癥患者的電生理監(jiān)測170張課件69神經(jīng)重癥患者的電生理監(jiān)測170張課件70神經(jīng)重癥患者的電生理監(jiān)測170張課件71神經(jīng)重癥患者的電生理監(jiān)測170張課件72神經(jīng)重癥患者的電生理監(jiān)測170張課件73神經(jīng)重癥患者的電生理監(jiān)測170張課件74神經(jīng)重癥患者的電生理監(jiān)測170張課件75神經(jīng)重癥患者的電生理監(jiān)測170張課件76神經(jīng)重癥患者的電生理監(jiān)測170張課件77神經(jīng)重癥患者的電生理監(jiān)測170張課件78神經(jīng)重癥患者的電生理監(jiān)測170張課件79神經(jīng)重癥患者的電生理監(jiān)測170張課件80神經(jīng)重癥患者的電生理監(jiān)測170張課件81神經(jīng)重癥患者的電生理監(jiān)測170張課件82神經(jīng)重癥患者的電生理監(jiān)測170張課件83神經(jīng)重癥患者的電生理監(jiān)測170張課件84神經(jīng)重癥患者的電生理監(jiān)測170張課件85神經(jīng)重癥患者的電生理監(jiān)測170張課件86神經(jīng)重癥患者的電生理監(jiān)測170張課件87神經(jīng)重癥患者的電生理監(jiān)測170張課件88神經(jīng)重癥患者的電生理監(jiān)測170張課件89神經(jīng)重癥患者的電生理監(jiān)測170張課件90神經(jīng)重癥患者的電生理監(jiān)測170張課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