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(píng)價(jià)總結(jié):神經(jīng)?？漆t(yī)師及特殊監(jiān)護(hù)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(hù)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(hù)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(fù)率增加60住院時(shí)間短40ortalitysHome/RehabLOS(days)圖12入住內(nèi)·外科1CU與入住神經(jīng)科學(xué)亞?？艭U(NSCU)的腦內(nèi)出血(ECH)預(yù)后數(shù)據(jù)的比較:GCs格拉斯哥昏迷量表評(píng)分;Rhab=族復(fù)總位時(shí)間:SEM=平均值的標(biāo)準(zhǔn)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(xué)亞?？艭UNSU)和其他病房(非NSu病房包括急性監(jiān)護(hù)病房、監(jiān)護(hù)病房以及內(nèi)科外科Cu)的住院時(shí)間分別與國家標(biāo)準(zhǔn)住院時(shí)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(shí)間:DRG=診斷相關(guān)組:SEM=平均值的標(biāo)準(zhǔn)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(fèi)=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(shí)ational,Inc.(HBS,.eden,wl,圖例顯示了神經(jīng)科學(xué)亞專科lCNsCu)和其他病房(非NCU病房包活急性監(jiān)護(hù)病房、監(jiān)護(hù)病房以及內(nèi)科/外科Cu》每例患者的花費(fèi)(s)分別與國標(biāo)準(zhǔn)花費(fèi)的差別(%);ADRG001和002=顱骨切開術(shù)臺(tái)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(biāo)準(zhǔn)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(fèi)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(hù)士配置護(hù)士3班倒護(hù)士長主班當(dāng)班護(hù)士當(dāng)班護(hù)士當(dāng)班護(hù)士當(dāng)班護(hù)士當(dāng)班護(hù)輪班護(hù)士取藥、送333病人NcCU的護(hù)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(hù)病房平面圖隔離病房隔離病房醫(yī)護(hù)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(ji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