动脉瘤性蛛网膜下腔出血患者继发脑血管痉挛相关因素分析及护理  

Analysis of related factors and nursing of cerebral vascular spasm secondary to aneurysmal subarachnoid hemorrhage

作　　者：蒲定琪 卿少玉 

机构地区：[1]中江县红十字会医院,四川中江618100 [2]成都市青白江区人民医院,四川成都610300

出　　处：《现代医药卫生》2010年第5期687-688,共2页Journal of Modern Medicine & Health

摘　　要：目的:探讨动脉瘤性蛛网膜下腔出血(SAH)患者继发脑血管痉孪相关因素及护理干预。方法:回顾性分析SAH患者25例的护理资料。结果:本组患者入院时病情的Hunt&Hess分级多在I～П级,Ш级以上者较少;CT脑池内积血量Fisher分级显示П和Ш级为多,约占总数的75%。脑血管DSA图像分析,表明动脉瘤性SAH后3～14d7例占28%,发生脑血管Ш痉挛;其中轻中度痉挛6例占25.2%,年龄33～71岁,外周血白细胞计数为(1.85±2.85)×l09/L,CT显示脑内血肿量为(7.12±1.56)ml;重度痉挛5例占18.3%,年龄21～45岁,外周血白细胞峰值为(12.5±3.65)×109/L,CT显示脑内血肿量为(21.13±2.30)ml。结论:加强相关临床因素的护理干预,对防治并发症的发生,降低残疾死亡率有重要意义。Objective：To Study the related factors and nursing intervention of cerebral vascular spasm secondary to aneurysmal subarachnoid hemorrhage （SAH）.Metbods： Recent 25 inpatients of aueurysmal SAH in our department were retrospectively analyzed.The patients took absolute bet rest after admission and received normal hemostasis and antivascular spasm treatment.Within 24h to 14d after admission, cerebral vascular DSA and CT angiography （CTA） were performed to determine the location and size of intracranial aneurysms. The occurrence related factors were analyzed and the nursing intervention was carried out.Results：In this group of patients, the disease status on admission was mostly in Hunt and Hess grade I - II ,little was more than grade III; in CT cerebral blood pool, most was Fisher grade II and III,accounting for 75% of the total cases.Cerebral DSA image showed that 7 cases .（28%） of aneurismal SAH developed grade III cerebral vascular spasm on 3-14 d. Among them, 6 cases were moderate, accounting for 25.2%,aged 33-71 years, peripheral blood WBC（1.85±2.85）x109/L, intracerebral hematoma volume（7.12±1.56）mL demonstrated by CT;5 cases were severe, accounting for 18.3%,aged 21-45years, peripheral blood WBC peak （12.5±3.65）×10^9/L, intracerebral hematoma volume （21.13±2.30） mL demonstrated by CT. Conclusion：The nursing intervention to the related factors of cerebral vascular spasm secondary to aneurysmal SAH has the important significance for preventing and treating complications,and reducing disability and mortality.

关 键 词：动脉瘤 蛛网膜下腔出血 脑血管痉孪 护理干预 

分 类 号：R5[医药卫生—内科学]