重度脑室出血患者实施颅内压监测和头腰侧交替引流的护理  

Nursing for intracranial pressure monitoring and alternating lumbar and lateral drainage in patients with severe ventricular hemorrhage

作　　者：李彩钱 蓝秀梅 卢雨婷 金爱娟 李沙沙 LI Cai-qian;LAN Xiu-mei;LU Yu-ting;JIN Ai-juan;LI Sha-sha

机构地区：[1]广东省清远市佛冈县人民医院,清远市511600

出　　处：《护理实践与研究》2018年第15期31-33,共3页Nursing Practice and Research

摘　　要：目的探讨重度脑室出血患者实施颅内压监测和头腰侧交替引流的护理策略。方法选取2015年1月至2017年1月我院收治的70例重度脑室出血患者为研究对象,对患者实施颅内压监测和头腰侧交替引流治疗后再行综合护理。调查干预后受试者住院时间、脑脊液达标时间、病死率等病情转归情况。采用脑损伤患者临床神经功能缺损程度量表(NDS)评估干预后受试者神经功能缺损程度。记录干预后受试者脑疝、颅内再出血、颅内感染、颅内积气、中枢性高热、穿刺孔脑脊液漏、低颅压等并发症发生情况。结果干预后受试者脑脊液达标时间为(10.37±1.56)d,住院时间为(23.57±2.85)d,受试者病死率为2.86%。干预后,受试者NDS评分为(10.34±1.97)分。干预后受试者中有16例发生脑疝,10例发生低颅压,8例发生颅内积气,12例发生颅内感染,24例发生颅内再出血,4例发生穿刺孔脑脊液漏,没有患者发生中枢性高热。结论采取适当的护理措施有利于提高重度脑室出血患者实施颅内压监测和头腰侧交替引流的治疗效果,改善患者预后。Objective To investigate the nursing strategies for intracranial pressure monitoring and alternating lumbar and lateral drainage in patients with severe ventricular hemorrhage.Methods To select 70 cases of patients with severe ventricular hemorrhage admitted to our hospital from January 2015 to January 2017 as research subjects.The patients underwent intracranial pressure monitoring and alternating head and lumbar drainage for comprehensive nursing.After the intervention,the patients'hospitalization time,cerebrospinal fluid compliance time,and mortality rate were investigated.The degree of neurological deficit in the subjects after intervention was assessed by clinical neurological function deficit score(NDS)in patients with brain injury.The complications of cerebral palsy,intracranial recurrent hemorrhage,intracranial infection,intracranial gas accumulation,central hyperthermia,puncture cerebrospinal fluid leakage and low intracranial pressure were recorded.Results After the intervention,the time to reach the cerebrospinal fluid of the subjects was(10.37±1.56)days,the hospitalization time was(23.57±2.85)days,and the mortality rate of the subjects was 2.86%.After the intervention,the subject had an NDS score of(10.34±1.97).After intervention,16 patients developed cerebral hernia,10 patients had low intracranial pressure,8 patients developed intracranial gas accumulation,12 patients developed intracranial infection,24 patients developed intracranial re-bleeding,and 4 patients developed puncture cerebrospinal fluid leakage.There was no central hyperthermia in the patient.Conclusion Appropriate nursing measures are beneficial to improve the therapeutic effect of intracranial pressure monitoring and alternating lumbar and lateral drainage in patients with severe ventricular hemorrhage,and improve the prognosis of patients.

关 键 词：重度脑室出血 颅内压监测 引流 护理策略 

分 类 号：R473.74[医药卫生—护理学]