大脑中动脉动脉瘤显微夹闭术中护理配合与体会  

Intraoperative nursing cooperation for micro-surgical clipping of middle cerebral artery aneurysms

作　　者：张丕宁[1] 姚燕婷[2] 甄莉[2] 栗世方[3] 唐万忠[3] 丰育功[3] 

机构地区：[1]青岛大学附属医院放射科,266003 [2]青岛大学附属医院手术室,266003 [3]青岛大学附属医院神经外科,266003

出　　处：《中华现代护理杂志》2015年第33期4011-4013,共3页Chinese Journal of Modern Nursing

基　　金：基金项目：2010年青岛市科技局资助课题（10-3-4-3-14-jch）

摘　　要：目的探讨大脑中动脉动脉瘤（MCAA）破裂后显微夹闭术术中护理配合工作的重要性。方法回顾性分析1997年1月—12013年12月202例MCAA患者施行显微夹闭术中的护理配合工作，男103例，女99例；共发现242个动脉瘤，其中MCAA215个，除一个未破的MCAA先栓塞外，其余214个MCAA行开颅夹闭212个、自体硬膜包裹2个。结果本组全部病例均采用Yasargil’s翼点入路，212个MCAA术中成功夹闭，174个未发生破裂（81．3％），40个术中发生破裂（18．7％），全部患者均得到控制低血压和低颅压的良好监护，经及时进行输血、输液等应对措施，保证了手术顺利完成。结论MCAA显微夹闭术中采用个性化控制性低血压、低颅压等措施，做好动脉瘤术中破裂的应急措施和熟练的术中配合，可使手术顺利进行，提高手术疗效。Objective To investigate the importance of nursing cooperation in the operation of middle cerebral artery aneurysm （MCAA） microsurgical clipping. Methods We retrospectively analyzed 202 cases （male 103 cases, female 99 cases） of MCAA patients who were underwent microsurgical clipping surgery （from January 1997 to December 2013）, and the importance of nursing cooperation in the process were analyzed. A total of 242 aneurysms were found during surgery of 212 cases underwent eraniotomy clipping, in which 215 cases were MCAA, and 2 cases underwent autologous dura wrapping, except one unbroken MCAA case was embolism. Results All patients in this group underwent Yasargil＇s pterional trans-sylvian approach, 212 MCAA surgery were successfully clipped. 174 cases were clipped without rupture （81.3%）, while rupture （ 18.7% ） occurred in 40 patients during surgery. All patients had been treated with controlled hypotension and intracranial hypotension, through timely blood transfusion, infusion and other response measures to ensure the successful completion of surgery. Conclusions It can help will the operation completed smoothly and improve surgical effects by personalized utilizing of controlled hypotension, brain tissue relaxation techniques and other measures in microsurgieal clipping of MCAA, as well as good nursing cooperation during the process of aneurysrns rupture.

关 键 词：大脑中动脉动脉瘤 显微手术夹闭 术中护理 

分 类 号：R472[医药卫生—护理学]