Multi-parameter Comparison Of The Difference Between The Professional NICU Managing And Non-professional NICU Managing

Objects:In order to explore a better management mode,to provide data for further optimizing and improving the implanting and the therapeutic and diagnosed efficiency in neurosurgical intensive care unit?NICU?,we analyze the changes of clinical management,therapeutic effect and other index before and after we changed the management mode in NICU in our hopstial.Method:The key point time was Aug 3^rd 2015 when our NICU was fully management by NICU professional doctors.Time periods were divided into two parts,one was from February 3,2015 to August 3,2015,the other was from August 4,2015to February 3,2015.All data of the management,therapy and diagnosis had been collected.The first half of this year was named as non-NICU professional doctors managing group?NNPDM group?,the second half of this year was named as NICU professional doctors managing group?NPDM group?.Their general demographic characteristics,therapeutic and diagnosed technology,medicine prescription and therapeutic effect were all collected and comparative analyzed.Age and other measurement data were expressed by average number±standard deviation.Enumeration data was expressed as rate?n%?or absolute numer?n?.All the data was analyzed by SPSS 20.0 with Student's T test,Chi-square test or rank-sum test.The difference was recognized statistically significant if p<0.050.Results:1.There was no significant difference in the two groups on general demographic characteristics.2.Medicine Prescribtion?1?antibiotics:The antibiotics prescribed in the patients in these two groups included?-lactamases?cephalosporin,cabapenem,?-lactamaseinhibitors?,methylmercadone,quinolones and antifungal drugs.The dosage of cephalosporin in NPDM group?336.33±104.32g?was less than NNPDM group?328.00±160.79g?,and the difference was statistically significant?P=0.004?.There was no significant difference in the two groups on dosage of other antibiotics.?2?dehydrating medicine:Dehydrating medicine prescribed in this research contains mannitol,glycerin fructose and furosemide.The dosage of mannitol in NPDM group?78700±10125ml?was less than NNPDM group?105783±25662ml?,the difference was statistically significant?P=0.037?.The dosage of furosemide in NPDM group?78700±10125ml?was less than NNPDM group?105783±25662ml?,the difference was statistically significant?P=0.006?.The dosage of glycerin fructose in NPDM group?44425±7499ml?was less than NNPDM group?42271±10007ml?,the difference had no statistically significant.3.The application of the therapeutic and diagnosed methods:The applies of arterial blood gas analysis in NPDM group?6.29±7.71times?was more frequent than NNPDM group?4.99±5.30times?,the difference was statistically significant?P<0.050?.The applies of fiberoptic bronchoscopic in NPDM group?35.67±4.89times?was more frequent than NNPDM group?15.67±5.54times?,the difference was statistically significant.4.The incidence of complications during hospitalization in NICU:Compared with NNPDM group,the incidence of water-electrolyte imbalance?P=0.044?in NPDM reduced significantly.There was no significant difference on the incidence of ventilator-associated pneumonia,liver&kidney dysfunction,intracranial infections and stress ulcer of upper gastrointestinal tracts between the two groups.5.Prognosis:Both the hospitalization day and the discharge rate were significantly higher in NPDM than the one in NNPDM group?p=0.009 and p<0.001 respectively?.While both the rate of patients transferred to other departments and the mortality were significantly lower than NNPDM group?p<0.00 and p=0.031 respectively?.Conclusion:NICU lead by professional doctors could control the dosage of drugs such as antibiotics and dehydrating drugs more reasonable,and could monitor patients'condition and take measures in time by applying more professional medical technologies.The incidence of complications was decreased,and the therapeutic effect was increased.It is good for standardize clinical medication habits,improve patients management level and improve patients'prognosis by acting NICU professional doctors managing.