颅内动脉瘤合并脑血管痉挛栓塞术后的观察与护理  

Observation and nursing after endovascular embolization of intracranial aneurysm combining with cerebral vascular angiospasm

作　　者：王兢[1] 宫淑芝[1] 魏勤[1] 荆雪虹[1] 高力[1] 

机构地区：[1]山东省医学影像学研究所,山东济南250021

出　　处：《医学影像学杂志》2007年第12期1354-1356,共3页Journal of Medical Imaging

摘　　要：目的:探讨颅内动脉瘤合并脑血管痉挛栓塞术后观察与护理的重要性。方法:本组36例颅内动脉合并脏血管痉挛患者入院72h内在全麻下行颅内动脉瘤栓塞术。术前、术中常规罂粟硷30mg/10ml持续静脉内泵入,术后持续泵入3d,给予尼莫通抗血管痉挛。术后第2天开始实施三高疗法,术后常规腰大池引流,放出血性脑脊液。结果:本组行颅内动脉瘤栓塞术后,32例恢复良好(可恢复工作,无明显神经系统功能障碍),2例持续昏迷自动出院;2例中度致残(轻度神经系统功能障碍,但生活能自理)。结论:利用护理手段干预4方面中的可控因素,如平均动脉压、颅内压、中心静脉压、血流速度(血液稀释度),使其控制在预设定目标范围内可保证脑的有效灌注压,预防CVS的发生。Objective： To discuss the importance of nursing after intracranial aneurysm endovascular embolization with cerebral va- sospasm.Methods：Thirty-six patients suffered from intracranial aneurysm with cerebral vasospasm were treated by endovascular embolization under general anesthesia within 72 hours after hospitalization. Papaverine was pumped continuously （30mg/10ml） pre-. intra-and after-operation in three days. Nimodipine was injected at the same time. ＂3 high＂ therapy was undergone in second day after embolization. Results： Thirty-two cases were completely recovered. Two cases coma persistendy and two cases midrange mutilation. Conclusion： Cranial perfusion pressure can be maintained efficiently through intervene four aspects： MABP （mean arterial blood pressure）, ICP （intraeranial pressure）, CVP （central venous pressure）, and BFR （blood flow rate） to control them in reasonable scope. Thus cerebral vasospasm can be prevented.

关 键 词：脑血管痉挛 介入性治疗 护理 

分 类 号：R742[医药卫生—神经病学与精神病学] R815[医药卫生—临床医学]