颅内动脉瘤介入栓塞术后并发症的危险因素及护理策略  

Risk factors analysis and nursing strategies for complications after interventional embolization of intracranial aneurysm

作　　者：于莉娜 霍颖[1] 丁丽娜 王迅[1] Yu Lina;Huo Ying;Ding Lina;Wang Xun(Department of Neurointervention Center,Dalian No.3 People′s Hospital,Dalian 116003,China;Department of Cardiovascular Medicine,Dalian No.3 People′s Hospital,Dalian 116003,China)

机构地区：[1]大连市第三人民医院神经介入中心,大连116003 [2]大连市第三人民医院心血管内科,大连116003

出　　处：《国际护理学杂志》2024年第15期2763-2767,共5页international journal of nursing

基　　金：大连市科技创新基金项目(2021JJ13SN55)

摘　　要：目的探讨颅内动脉瘤介入栓塞术后并发症的危险因素,寻找对应的护理对策。方法采用回顾性调查,对大连市第三人民医院神经介入中心在2021年1月至2023年1月诊治的80例颅内动脉瘤介入栓塞术患者进行资料分析,并以存在术后再破裂出血的49(61.25%)例为观察组,未出现术后再破裂出血的31(38.75%)例为对照组,并对其进行单因素分析、Logistic回归分析及ROC曲线分析。分析颅内动脉瘤介入栓塞术后再破裂出血产生的相关危险因素,并提出对应的护理策略。结果单因素分析分析结果显示:两组性别、病程、吸烟史、心脏病史、糖尿病史、动脉瘤位置、动脉瘤直径差异无统计学意义(P>0.05);两组年龄、高血压病史、宽颈动脉瘤情况、哥拉斯哥昏迷评分(GCS)、蛛网膜下腔出血Hunt-Hess分级差异有统计学意义(P<0.05)。Logistic回归分析结果显示:年龄、高血压病史以及蛛网膜下腔出血Hunt-Hess分级为导致颅内动脉瘤介入栓塞术后再破裂出血形成的独立危险因素。ROC曲线分析结果显示:上述影响因素曲线下面积分别为0.730、0.729、0.778,敏感性较高。结论颅内动脉瘤介入栓塞术后再破裂出血产生可能与年龄、高血压病史以及蛛网膜下腔出血Hunt-Hess分级有关,因此在护理中应继续优化术后预防性护理流程,减少再破裂出血的产生。ObjectiveTo explore the risk factors of complications after interventional embolization of intracranial aneurysm and find the corresponding nursing countermeasures.MethodsA retrospective study was conducted to analyze the data of 80 patients with intracranial aneurysm who received interventional embolization from the neurointerventional intervention center of Dalian No.3 People's Hospital from January 2021 to January 2023.The 49 cases(61.25%)with postoperative recurrent hemorrhage were designated as the observation group,while the 31 cases(38.75%)without postoperative recurrent hemorrhage were designated as the control group.Single factor analysis,Logistic regression analysis and ROC curve analysis were performed on the two groups.ResultsUnivariate analysis showed that there were no significant differences in gender,course of disease,smoking history,history of heart disease,history of diabetes,aneurysm location and aneurysm diameter between the two groups(P>0.05).There were significant differences in age,history of hypertension,presence of wide-necked aneurysm,Glasgow Coma Scale(GCS)score and Hunt-Hess grade of subarachnoid hemorrhage between the two groups(P<0.05).The results of Logistic regression analysis showed that age,history of hypertension and subarachnoid hemorrhage Hunt-Hess grade were independent risk factors for the formation of rerupture and bleeding after interventional embolization of intracranial aneurysm.ROC curve analysis results showed that the areas under the curves of the above influencing factors were 0.730,0.729 and 0.778,respectively,indicating high sensitivity.ConclusionsThe risk of recurrent intracranial aneurysm rupture after endovascular embolization may be associated with age,history of hypertension and Hunt-Hess grade of subarachnoid hemorrhage.Therefore,in nursing care,the postoperative preventive care process should be continuously optimized to reduce the incidence of recurrent rupture.

关 键 词：颅内动脉瘤介入栓塞术 再破裂出血 护理策略 

分 类 号：R473.74[医药卫生—护理学]