院外随访干预对脑出血术后昏迷患者生活质量的良性影响

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1、授予单位代码10089学号或申请号13717_HebeiMedicalUniversity硕士学位论文在职科学学位院外随访干预对脑出血术后昏迷患者生活质量的良性影响学位申请人：郑俊青导师：何文英教授专业：护理学二级学院：第二医院2015年3月河北医科大学学位论文使用授权及知识产权归属承诺本学位论文在导师（或指导小组）的指导下，由本人独立完成。本学位论文研究所获得的研究成果，其知识产权归河北医科大学所有。河北医科大学有权对本学位论文进行交流、公幵和使用。凡发表与学位论文主要内容相关的论文，第一署名为单位河北医科大学，试验材料、原始数据、申报的专利等

2、知识产权均归河北医科大学所有。否则，承担相应法律责任。V仏,^2015年T八j'•?••••‘-f''河北医科大学研究生学位论文独创性声明本论文是在导师指导下进行的研究工作及取得的研究成果，除了文中特别加以标注和致谢等内容外，文中不包含其他人己经发表或撰写的研究成果，指导教师对此进行了审定。本论文由本人独立撰写，文责自负。研究生签名：k导师签章：2015年月日目录中文摘要··············································································1英文摘要······

3、········································································2研究论文院外随访干预对脑出血术后昏迷患者生活质量的良性影响前言··············································································3材料与方法·····································································5结果················

4、·····························································11附表·············································································14讨论·············································································16结论·················································

5、····························19参考文献·······································································19综述脑出血患者延续性护理干预的现状·····································30致谢···················································································36个人简历······················

6、·······················································37中文摘要院外随访干预对脑出血术后昏迷患者生活质量的良性影响摘要目的：评价院外随访干预对脑出血术后昏迷患者生活质量的影响，以期为建立规范化的院外随访护理干预方案提供理论依据。方法：本研究收集自2013年2月至2014年6月我科收治的88例脑出血患者，依据研究纳入标准的选取病例79例（除去失访患者），依据随机原则分入实验组和对照组，实验组给予实验研究所设计的系统化随访，对照组给予常规出院宣教和被动电话及网络回访指导。观察6个月后院外随访干

7、预对患者生存质量，家属满意度，并发症发生率的影响。结果：院外随访干预可以显著改善脑出血术后昏迷患者的：转醒率（P=0.011），肺部感染（P=0.021），泌尿系感染（P=0.000），电解质紊乱（P=0.000），压疮（P=0.000），PICC带管率（P=0.018），PICC感染率（P=0.000），意外跌落（P=0.000），皮肤黏膜（角膜）溃疡（P=0.000）。能显著改善患者家属的满意度（P=0.005）。对于闭合气管切开（P=0.087），脑积水（P=0.102），再出血(P=0.078)，应激性溃疡（P=0.061）和避免癫痫发作

8、（P=0.074），均无显著影响。结论：接受了院外随访干预的脑出血术后昏迷患者的病情得到改善，并发症出现的比例显著降低，意外事件的发生率