1例脑动静脉畸形破裂出血并发神经源性肺水肿患者的护理  

Nursing care of a patient with intracerebral hemorrhage due to ruptured cerebral arteriovenous malformation and neurogenic pulmonary edema

作　　者：曹秀敏 唐冬梅[1] CAO Xiumin;TANG Dongmei(Department of Neurological Surgery,Taicang First People’s Hospital,Taicang,Jiangsu,215413)

机构地区：[1]苏州大学附属太仓医院,江苏省太仓市第一人民医院神经外科,江苏太仓215413

出　　处：《中西医结合护理》2022年第8期154-159,共6页Chinese Journal of Integrative Nursing

摘　　要：本文总结1例脑动静脉畸形破裂出血并发神经源性肺水肿患者的护理体会。术后在严密监测神志、瞳孔、生命体征变化基础上,对正常灌注压突破综合征进行早期识别及干预,在控制性降压及颅内压的同时保证有效的脑灌注压;做好神经源性肺水肿的早期识别及护理,在扩容的同时预防肺水肿进一步加重;做好患者的呼吸道管理及容量管理,给予正确的肺保护通气策略,细化出入量;对慢性意识障碍进行促醒康复,促进患者早日康复。This paper summarized the nursing management for a patient with intracerebral hemorrhage due to ruptured cerebral arteriovenous malformation and neurogenic pulmonary ede⁃ma.Based on the monitoring of postoperative vital signs of the patient,efforts were made in the following aspects:Early identification and intervention on normal perfusion pressure break⁃through syndrome;Ensuring the effective cerebral perfusion pressure during control of blood pres⁃sure and intracranial pressure;Early identification and nursing of neurogenic pulmonary edema;Enhancing the postoperative airway,fluid and volume management;Providing lung protective ventilation strategy;Carrying out awakenings and awareness recovery for the patient with chronic disorders of consciousness.

关 键 词：脑动静脉畸形 神经源性肺水肿 促醒康复 正常灌注压突破综合征 呼吸道管理 

分 类 号：R473.6[医药卫生—护理学]