1例颅内外血运重建术后脑出血围术期护理  

Perioperative Nursing Care for One Case of Cerebral Hemorrhage After Intracranial and Extracranial Revascularization

作　　者：罗媛榕 辛欣 于文君[1] 杨瑶 房莹 滕雪 LUO Yuanrong;XIN Xin;YU Wenjun;YANG Yao;FANG Ying(TENG Xue Operating Room,Nanjing Brain Hospital,Nanjing Jiangsu 210029,China)

机构地区：[1]南京脑科医院手术室,江苏南京210029

出　　处：《中国卫生标准管理》2020年第22期157-159,共3页China Health Standard Management

摘　　要：目的总结1例烟雾病患者颅内外血运重建术后麻醉复苏中急性脑出血护理配合。方法护理要点包括做好术前访视,评估工作。手术过程中严密监测生命体征,血管吻合时协助医生维持血压在合适范围。术后严密观察生命体征,做好非计划重返急诊手术护理配合,及时上报护士长安排人员,按照科室非计划重返急诊手术配合流程为抢救患者生命争分夺秒。做好术中体温监测,体温保护,皮肤护理,预防压力性损伤、下肢深静脉血栓形成。结果患者手术成功,恢复良好,术后9天顺利出院。结论颅内外血运重建术可以加大大脑供血,术后加强病情观察及生命体征监测,颅内再出血一旦发生按照流程做好非计划重返急诊手术护理配合。Objective To make a summary on the nursing cooperation during acute cerebral hemorrhage in anesthesia recovery for a patient with moyamoya disease after intracranial and extracranial revascularization.Methods The main points of nursing care include preoperative visits and evaluation.Vital signs were closely monitored during the surgery,and the doctors were assisted to maintain blood pressure within an appropriate range during vascular anastomosis.After the surgery,the vital signs were closely observed with well-done nursing cooperation for unplanned readmission to emergency surgery.The head nurse was promptly reported to arrange personnel,and no time was wasted to save the patient's life in accordance with the department's cooperation process for unplanned readmission to emergency surgery.A good job was done in intraoperative body temperature monitoring,body temperature protection,skin care,as well as the prevention of stress injury and lower-limb deep-vein thrombosis.Results The surgery was accomplished successfully,and the patient recovered well and left the hospital 9 days after the surgery.Conclusion Intracranial and extracranial revascularization can increase cerebral blood supply.The observation of disease condition and monitoring of vital signs shall be strengthened after surgery.A good job should be done in nursing cooperation according to the procedure for unplanned readmission to emergency surgery once intracranial rebleeding occurs.

关 键 词：烟雾病 颅内外血运重建术 脑出血 麻醉复苏 非计划重返手术 护理配合 

分 类 号：R743[医药卫生—神经病学与精神病学]