脑动静脉畸形介入治疗并发症的观察与护理  

The nursing care of Onyx embolotherapy for cerebral arteriovenous malformations

作　　者：王琨[1] 薛艳[1] 

机构地区：[1]山东大学附属省立医院,山东济南250021

出　　处：《医学影像学杂志》2010年第10期1545-1547,共3页Journal of Medical Imaging

摘　　要：目的：探讨脑动静脉畸形（AVM）栓塞治疗并发症的观察与护理。方法：回顾性分析152例脑动静脉畸形介入治疗术中并发症的发生,总结护理观察经验。结果：AVM位于额顶叶87例、顶枕叶34例、颞顶叶17例、基底节区7例、小脑半球7例。畸形团直径小于3cm的56例,3~6cm的72例,大于6cm的24例。注射Onyx栓塞脑动静脉畸形,畸形团完全栓塞42例,畸形团栓塞80%以上62例,畸形团栓塞50%~80%34例,畸形团栓塞50%以下14例。术中并发症：2例栓塞术中发生粘管;8例栓塞术后出现肢体偏瘫,由于护理观察及时,经解痉、降低颅内压、促进微循环供血等治疗好转;1例脑出血急症开颅清除血肿,肢体留有偏瘫。其余病例无严重并发症。结论：术前充分准备,术中预见性观察与处理对保证栓塞的疗效,减少并发症的发生具有重要的意义。Objective：To explore nursing care of Onyx embolotherapy for cerebral arteriovenous malformations（AVM）.Methods：152 cases of AVM embolized with Onyx were analyzed retrospectively and summarized the nursing experience.Results：The AVM located at frontal-parietal lobe in 87 cases,parietal-occipital lobe in 34 cases,temporal-parietal lobe in 17 cases,basal ganglia area in 7 cases,cerebellar hemisphere in 7 cases and the AVM diameter was smaller than 3 cm in 56 cases,3～6 cm in 72 cases,larger than 6 cm in 24 cases.Effective embolization was achieved in all 152 cases,with complete embolization in 42 cases,more than 80% embolization in 62 cases,50%～80% embolization in 34 cases,less than 50% embolization in 14 cases.Adhesion to the catheter happened in 2 cases,mild hemiparalysis happened in 8 cases,in which the hemiparalysis was markedly improved after administration of vasoactive medicine to decrease the intracranial pressure and to enhance the microcirculation.Intracranial hemorrhage happened in 1 case who had mild hemiparalysis remained after immediate hematoma removement by performance of craniotomy.No severe complications happened in other cases.Conclusion：Full preparation before the surgery and caring nursing in surgery is very important to ensure the curative effect.

关 键 词：脑动静脉畸形 介入治疗 并发症 护理 

分 类 号：R743.4[医药卫生—神经病学与精神病学] R815[医药卫生—临床医学]