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国际中医药研究

International Research in Chinese Medicine

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International Research in Chinese Medicine. 2025; 5: (1) ; 10.12208/j.ircm.20250004 .

Treatment effect analysis of the integrated medical, nursing and health management model of Chinese and western medicine in patients with tracheotomy after stroke
中西医结合医护康一体化管理模式下卒中后气切患者的疗效分析

作者： 谢婉怡1, 何美瑭1, 黄文豪2, 蔡秀薇2, 赖家杰2, 邹汉宏2, 吴小欣2, 李敏2 *

1 广州中医药大学第五临床医学院 广东广州

2 广东省第二中医院 广东广州

*通讯作者： 李敏,单位： 广东省第二中医院 广东广州；

引用本文: 谢婉怡, 何美瑭, 黄文豪, 蔡秀薇, 赖家杰, 邹汉宏, 吴小欣, 李敏 中西医结合医护康一体化管理模式下卒中后气切患者的疗效分析[J]. 国际中医药研究, 2025; 5: (1) : 22-28.
Published: 2025/3/16 10:26:15

摘要

目的 探讨中西医结合医护康一体化管理模式下卒中后气切患者拔管的临床疗效。方法 回顾性纳入2022年2月至2024年1月广东省第二中医院针灸康复科收治的脑卒中后气管切开患者，将2022年2月至2023年1月接受常规中西医康复治疗的住院患者作为对照组，2023年2月至2024年1月的住院患者作为观察组，在医护康一体化管理模式下接受中西医康复治疗。收集患者的一般资料，比较两组的拔管率和拔管时间，以及治疗前后的炎症指标和血气指标。结果 治疗结束后，观察组中有48例成功拔管，拔管率达71.64%；而对照组中有35例成功拔管，拔管率为53.85%。观察组的拔管率高于对照组（P＜0.05），拔管时间较对照组更短（P＜0.05）。经过治疗，观察组和治疗组的WBC、NE%、hs-CRP、PCT和PaCO2的数值比治疗前低（P＜0.05），PaO2和OI的数值则比治疗前增加（P＜0.05）。治疗后，观察组的WBC、NE%、hs-CRP、PCT和PaCO2水平低于对照组（P＜0.05），观察组的PaO2和OI水平均高于对照组（P＜0.05）。结论 对卒中后气管切开患者实施医护康一体化管理，能改善炎症及血气指标，促进肺部感染好转，提高拔管率，缩短拔管时间。

关键词： 脑卒中；气管切开；拔管；医护康一体化管理

Abstract

Objective To explore the clinical efficacy of extubation in patients with tracheostomy after stroke under the integrated management model of traditional Chinese and Western medicine.
Methods A retrospective study included patients with respiratory dysfunction and tracheostomy due to nerve injury admitted to Guangdong Second Traditional Chinese Medicine Hospital from February 2022 to January 2024. Patients who received conventional traditional Chinese and Western medicine rehabilitation treatment from February 2022 to January 2023 were designated as the control group, while those admitted from February 2023 to January 2024 who received integrated Chinese and Western medicine rehabilitation under the integrated management model were the observation group. General patient data were collected, and the extubation rate and time, as well as changes in inflammatory markers and blood gas analysis indicators before and after treatment were compared between the two groups.
Results After treatment, 48 patients in the observation group successfully underwent extubation, with an extubation rate of 71.64%; whereas 35 patients in the control group successfully underwent extubation, with an extubation rate of 53.83%. The extubation rate in the observation group was significantly higher than that in the control group (P＜0.05), and the extubation time in the observation group was also shorter than that in the control group (P＜0.05). After treatment, the values of WBC, NE%, hs-CRP, PCT and PaCO2 in both the observation group and the treatment group decreased compared to before treatment (P＜0.05), while the values of PaO2 and OI increased compared to before treatment (P＜0.05). Post-treatment, the levels of WBC, NE%, hs-CRP, PCT and PaCO2 in the observation group were significantly lower than those in the control group, with these differences being statistically significant (P＜0.05). After treatment, the levels of PaO2 and OI in the observation group were significantly higher than those in the control group, and these differences were also statistically significant (P＜0.05).
Conclusion   Implementing integrated medical care management for stroke patients with tracheostomy can improve inflammatory and blood gas indicators, promote the improvement of pulmonary infections, increase the extubation rate, and shorten the extubation time.

Key words： Stroke; Tracheotomy; Extubation; Integrated medical; Nursing and health management

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