高血压脑出血46例围术期护理  

Perioperative nursing care of 46 patients with hypertensive cerebral hemorrhage

作　　者：毛英[1] 罗中兵[1] 张希[1] 冯娟[1] 华莎[1] 

机构地区：[1]广州军区武汉总医院,湖北武汉430070

出　　处：《齐鲁护理杂志（中旬刊）》2012年第4期12-14,共3页Journal of Qilu Nursing

摘　　要：目的:探讨高血压脑出血患者手术后的好转出院率和相关并发症,分析其围术期护理方法。方法:对46例高血压脑出血患者进行围术期护理干预,记录入院和出院血流动力学变化,观察手术后好转出院率和术后并发症。结果:高血压脑出血患者手术后好转出院率为58.7%;年龄<60岁患者好转出院率显著高于年龄≥60岁患者(P<0.05);术前脑疝患者好转出院率低于无脑疝患者(P<0.01)。入院时SBP为(191.8±27.5)mm Hg,DBP为(111.5±13.9)mm Hg,高于出院时SBP(135.6±10.3)mmHg和DBP(84.6±8.7)mm Hg(P<0.05)。术后感染率32.6%,主要为呼吸道细菌感染,前三位病原菌为:铜绿假单胞菌、肺炎克雷伯菌和MRSA;感染率高低与住院天数>15 d和气管切开有关。结论:高血压脑出血患者病死率高,护理工作量大,护理的重点是控制血压、观察生命体征和防止院内感染。Objective： To investigate the improvement rate of the patients at discharge and the related complications after operation and analyze perioperative nursing methods. Methods ： The perioperative nursing intervention was given to 46 patients with hypertensive cerebral hemorrhage. The hemodynamic changes were recorded on admission and at discharge, and the improvement rate of the patients at dis- charge and the related postoperative complications were observed. Results ： The improvement rate of the patients at discharge was 58.7% and it was significantly higher in the patients below 60 years old than those over 60 years （ P 〈 0.05 } ; the improvement rate of the patients with cerebral hernia at discharge was lower than those without cerebral hernia before surgery { P 〈 0.01 } ; SBP{ 191.8 ~ 27.5 } mmHg and DBP { 111.5 ~ 13.9） mmHg of the patients significantly higher on admission than SBP（ 135.6 ~ 10.3 } mmHg and DBP{ 84.6 ~ 8.7 ） mmHg at discharge （ P 〈 0.05 }. The postoperative infection rate was 32.6% and it was mainly bacterial infection of the respiratory tract, the top three pathogenic bacteria were Pseudomonas aeruginosa, Klebsiella pneumoniae and MRSA; the infection rate was related to the length of hospital stay （ 〉 15 days） and tracheotomy. Conclusion： The fatality rate was higher in the patients with hypertensive cerebral hemorrhage, therefore nursing care should focus on the control of blood pressure, close observation of vital signs and prevention of nosoco- mial infection.

关 键 词：护理 高血压 脑出血 病死率 感染 

分 类 号：R473.6[医药卫生—护理学]