颅内动脉瘤患者开颅夹闭术中应用等体温与室温冲洗液的护理效果对比  

Comparison of Nursing Effects of Isobody Temperature and Room Temperature Irrigation Solution in Patients with Intracranial Aneurysm during Craniotomy and Clipping

作　　者：黄启康 HUANG Qikang(Operating Room,Union Hospital Affiliated to Fujian Medical University,Fuzhou,Fujian Province,350000 China)

机构地区：[1]福建医科大学附属协和医院手术室,福建福州350000

出　　处：《中外医疗》2021年第22期144-146,150,共4页China & Foreign Medical Treatment

摘　　要：目的探究颅内动脉瘤患者开颅夹闭术中应用等体温与室温冲洗液的护理效果对比。方法方便选取2017年1月—2018年12月于该院接受治疗的102例颅内动脉瘤患者为受试对象,随机数表法分为观察组与对照组,各51例。对照组予以常温冲洗液护理,观察组予以等体温冲洗液护理。比较两组患者围术期指标及术后7 d血流动力学指标,记录术后14 d内脑血管痉挛(CVS)发生情况,并于患者出院时评估其认知功能及生活能力。结果两组患者手术时间、术中出血量、冲洗液量比较均差异无统计学意义(P>0.05),而观察组患者术后头晕时间、疼痛时间、下床活动时间分别为(3.25±1.06)、(2.34±0.96)、(3.48±1.28)d均明显低于同期对照组(5.36±1.24)、(3.25±1.14)、(5.34±1.36)d,差异有统计学意义(t=9.237、4.360、7.112,P<0.05);术后7 d,观察组患者MCA的Vs、Vd、Vm、PI分别为(117.86±32.65)、(50.26±19.73)、(70.76±6.29)cm/s、(1.64±0.86)均明显高于同期对照组的(86.29±22.04)、(42.62±15.17)、(61.11±7.09)cm/s、(0.75±0.17),差异有统计学意义(t=5.723、2.192、7.271、7.250,P<0.05);术后14 d,观察组CVS发生率为3.9%(2/51),显著低于对照组的15.7%(8/51),差异有统计学意义(χ^(2)=3.991,P<0.05);出院时,观察组患者MMSE量表评分为(28.12±1.08)分明显高于同期对照组的(26.67±1.06)分,差异有统计学意义(t=6.843,P<0.05);而观察组ADL量表评分(23.14±2.12)分明显低于同期对照组的(26.98±2.27)分,差异有统计学意义(t=8.829,P<0.05)。结论于开颅夹闭术中使用等体温冲洗液护理更有利于颅内动脉瘤患者治疗,效果理想,且术后CVS发生率低,安全性高。Objective To explore the comparison of the nursing effects of isothermal and room temperature washing solutions during craniotomy and clipping in patients with intracranial aneurysm.Methods A total of 102 patients with intracranial aneurysms who were treated in this hospital from January 2017 to December 2018 were conveniently selected as subjects.Random number table method was divided into observation group and control group,with 51 cases in each group.The control group was given care of normal temperature washing solution,and the observation group was given the care of isothermal washing solution.The perioperative indexes and hemodynamic indexes of 7 days after operation were compared between the two groups of patients,the occurrence of cerebral vasospasm(CVS)within 14 days after operation was recorded,and the cognitive function and living ability of the patients were evaluated when they were discharged from the hospital.Results There were no statistically significant differences in the operation time,intraoperative blood loss,and the amount of irrigation fluid between the two groups of patients(P>0.05),while the postoperative dizziness time,pain time,and time of getting out of bed in the observation group were(3.25±1.06)d,(2.34±0.96)d,(3.48±1.28)d were significantly lower than the control group(5.36±1.24)d,(3.25±1.14)d,(5.34±1.36)d,the difference was statistically significant(t=9.237,4.360,7.112,P<0.05);7 d after operation,the Vs,Vd,Vm and PI of MCA of observation group were(117.86±32.65)cm/s,(50.26±19.73)cm/s,7 d after operation,(70.76±6.29)cm/s and(1.64±0.86)were significantly higher than(86.29±22.04)cm/s,(42.62±15.17)cm/s,(61.11±7.09)cm/s,(0.75±0.17),the difference was statistically significant(t=5.723,2.192,7.271,7.250,P<0.05);14 d after operation,the incidence of CVS in the observation group was 3.9%(2/51),which was significantly lower than the control group 15.7%(8/51)of the patients,the difference was statistically significant(χ^(2)=3.991,P<0.05);at discharge,the MMSE score of the observa

关 键 词：颅内动脉瘤 体温 血流动力学 脑血管痉挛 疗效 

分 类 号：R47[医药卫生—护理学]