临床护理路径对侧脑室引流治疗的自发性脑出血患儿临床疗效及脑积水发生情况的影响  

Clinical nursing pathway on side ventricular drainage treatment of spontaneous intracerebral hemorrhage in children with clinical efficacy and hydrocephalus

作　　者：宋艳红 Song Yanhong(Neurosurgery Department,Children's Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学附属儿童医院神经外科,河南郑州450000

出　　处：《国际护理学杂志》2019年第6期831-836,共6页international journal of nursing

摘　　要：目的探讨临床护理路径对侧脑室引流治疗的自发性脑出血(Intracerebral Hemorrhage,ICH)患儿临床疗效及脑积水发生情况的影响.方法回顾该院2013年1月~2017年10月收治的行侧脑室引流治疗的ICH患儿72例,其中2013年1月~2015年1月给予常规护理的ICH患儿34例标记为对照组,2015年1月~2017年10月在常规护理的基础上联合临床护理路径的患儿38例标记为观察组.患儿均进行侧脑室引流治疗,比较两种护理模式下患儿引流持续时间、引流量、血肿清除时间等围治疗期指标差异.患儿治疗后均随访6个月,比较两组患儿治疗后脑积水、颅内感染、再出血等并发症发生情况,以及治疗后3个月、6个月美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分、Barthel指数评分(The Barthel Index of ADL)以及脑出血评分量表-Ⅱ(Intracerebral Hemorrhage II,ICH-Ⅱ)评分差异,并对患儿家属进行护理满意度调查,分析两种护理模式下患儿家属满意度的差异.结果两组患儿引流持续时间、引流量、血肿清除率、引流管拔除时间组间比较,差异均无统计学意义(均P>0.05).观察组治疗后脑积水发生率明显低于对照组,差异有统计学意义(P<0.05);两组患儿治疗后颅内感染、颅内积气、引流不畅以及再出血发生率组间比较,差异均无统计学意义(均P>0.05);观察组患儿治疗后并发症总发生率显著低于对照组患儿,差异有统计学意义(P<0.05).两组患儿NIHSS、Barthel以及ICH-Ⅱ评分比较,差异均无统计学意义(均P>0.05);两组患儿治疗后3个月、6个月NIHSS、ICH-Ⅱ评分显著低于治疗前,Barthel评分显著高于治疗前,且观察组患儿治疗后3个月、6个月NIHSS、ICH-Ⅱ评分显著低于对照组,Barthel评分显著高于对照组,差异均有统计学意义(均P<0.05).观察组患儿护理总满意度显著高于对照组,差异有统计学意义(P<0.05).结论临床护理路径在ICH患儿侧脑�Objective To explore the clinical efficacy and the influence for hydrocephalus of clinical nursing pathway on side ventricular drainage treatment of spontaneous intracerebral hemorrhage(ICH)in children.Methods A total of 72 ICH children admitted to the hospital from January 2013 to October 2017 and treated with lateral ventricular drainage were reviewed.Among them,34 cases of children with ICH who received routine care from January 2013 to January 2015 were labeled as the control group,and 38 cases of children who received combined clinical care on the ba-sis of routine care from January 2015 to October 2017 were labeled as the observation group.All the children were trea-ted with lateral ventricular drainage,and the differences in perioperative indicators such as duration of drainage,re-moval time of drainage hematoma and so on were compared between the two nursing modes.Patients were followed up for 6 months after treatment,and the incidence of complications such as hydrocephalus,intracranial infection and re-hemorrhage after treatment were compared between the two groups and 3 months and 6 months after treatment,National Institute of Health Stroke Scale(NIHSS),the Barthel Index of ADL and Intracerebral Hemorrhage-Ⅱ(ICH-Ⅱ)score differences were compared.In addition,the nursing satisfaction of the patients'families was investigated to analyze the differences in the satisfaction of the patients'families under the two nursing modes.Results There was no significant difference in the duration of drainage,drainage volume,hematoma clearance rate,and drainage tube removal time be-tween the two groups(P>0.05).The incidence of hydrocephalus in the observation group was significantly lower than that in the control group,and difference was statistically significant(P<0.05).There was no significant difference in the incidence of intracranial infection,intracranial pneumocephalus,obstructed drainage,and recurrent bleeding be-tween the two groups after treatment(P>0.05).The total incidence of complications in the observat

关 键 词：自发性脑出血 侧脑室引流 临床护理路径 应用价值 

分 类 号：R473.72[医药卫生—护理学]