手术治疗颅内静脉窦血栓形成合并脑出血所致脑疝患者的护理

发布时间：2018-03-26 09:03

本文选题：颅内静脉窦出血　切入点：脑出血　出处：《血栓与止血学》2016年06期

【摘要】：目的探讨手术治疗颅内静脉窦血栓形成(CVST)合并脑出血所致脑疝患者的有效护理干预方法。方法选择2010年1月至2015年2月我院收治的36接受血肿清除术联合去骨瓣减压术治疗的CVST合并脑出血所致脑疝患者,按就诊顺序分为对照组与观察组两组,各18例。对照组给予常规护理,观察组予以强化护理,包括心理护理、颅内高压观察、抗凝用药护理、康复指导等,观察两组恢复情况,统计术后并发症发生率,出院时采用格拉斯哥预后(GOS)表评定其恢复情况,随访6~12个月,统计血栓复发、颅内出血再发率,采用改良Rankin量表(mRS)表评定患者预后。结果 1观察组整体并发症发生率低于对照组(P0.05);2观察组术后恢复良好、轻度残疾比例高于对照组,重度残疾及死亡比例低于对照组,但对比差异无统计学意义(P0.05);3术后6个月、12个月,观察组mRS评分降低幅度高于对照组(P0.05);4观察组静脉窦血栓、颅内出血新发及复发例数均低于对照组,但对比差异无统计学意义(P0.05)。结论在采用手术治疗的CVST合并脑出血所致脑疝患者中应用强化护理干预,可减少血栓、出血性不良事件,改善预后。
[Abstract]:Objective to explore the effective nursing intervention method for patients with cerebral hernia caused by cerebral hemorrhage caused by intracranial venous sinus thrombosis (CVST). Methods 36 patients treated in our hospital from January 2010 to February 2015 were treated with hematoma removal combined with bone flap removal. CVST patients with cerebral hernia due to intracerebral hemorrhage treated by decompression, The control group was given routine nursing, and the observation group was given intensive nursing, including psychological nursing, intracranial hypertension observation, anticoagulant medication nursing, rehabilitation guidance and so on. The incidence of postoperative complications was counted and the recovery was evaluated by Glasgow prognostic GOS at discharge. The recurrence of thrombus and the recurrence rate of intracranial hemorrhage were recorded during the follow-up period of 612 months. Results 1 the overall complication rate in the observation group was lower than that in the control group (P 0.05), the proportion of mild disability was higher than that in the control group, and the proportion of severe disability and death was lower than that in the control group. However, there was no significant difference between the two groups at 6 months and 12 months after operation. The decrease of mRS score in the observation group was higher than that in the control group (P 0.05). The number of new and recurrent cases of intracranial hemorrhage in the observation group was lower than that in the control group. Conclusion intensive nursing intervention can reduce thrombus, haemorrhage adverse events and improve prognosis in patients with cerebral hernia caused by CVST combined with intracerebral hemorrhage.
【作者单位】：朝阳市中心医院;
【分类号】：R473.6

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