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目的:探究ICU转出患者的重返原因,并实施针对性的管理策略,减少患者的非计划性重返。方法:回顾性分析2013~2014年两周内ICU入住次数≥2次的患者资料,对患者的临床特征、重返ICU原因进行统计分析,找出ICU转出重返的主要影响因素,并制定相关的管理对策。结果:共统计2947例ICU患者,其中79例在两周内发生重返,重返率为2.70%,从疾病因素来看,呼吸道问题、心血管问题和术后并发症是导致ICU患者重返的重要因素,分别占51.90%、17.70%和15.20%,多因素回归分析结果显示,APACHE II评分、人工气道、机械通气时间、获得性肺炎、APS、内科慢性疾病是影响患者重返率的独立风险因素。结论:普通病房ICU转出患者后续的监护不足,是导致ICU患者重返的重要因素,在ICU患者转出前要充分评估患者病情,做好与普通病房护士的交接工作,加强患者的呼吸道护理,全面提高护士的专业水平,防止患者重返ICU。
OBJECTIVE: To explore the reasons for the return of ICU patients and to implement targeted management strategies to reduce the unplanned return of patients. Methods: The data of patients with ICU occupancy more than or equal to 2 times within two weeks from 2013 to 2014 were analyzed retrospectively. The clinical characteristics and the reason of returning to the ICU were analyzed statistically to find out the main influencing factors of ICU withdrawal and return. Related management strategies. Results: A total of 2947 patients with ICU were enrolled in this study. Of them, 79 patients returned to hospital within two weeks with a rate of 2.70%. According to the disease factors, respiratory problems, cardiovascular problems and postoperative complications led to the return of ICU patients Respectively, accounting for 51.90%, 17.70% and 15.20% respectively. The results of multivariate regression analysis showed that APACHE II score, artificial airway, mechanical ventilation time, acquired pneumonia, APS and medical chronic diseases were the influential factors Independent risk factors. CONCLUSION: The follow-up under-custody of patients with ICU out of ordinary ward is an important factor leading to the return of patients with ICU. Patients should be fully assessed before switching out of ICU, and the transfer should be done with common ward nurses to enhance respiratory care, Comprehensively improve the professional level of nurses to prevent patients from returning to the ICU.