血流导向装置植入治疗动脉瘤患者术后并发症的护理观察与应对  

Nursing Observation and Response to Postoperative Complications in Patients with Aneurysm Treated with PED

作　　者：于志伟[1] 关欣[1] Yu Zhiwei;Guan Xin(Xuanwu Hospital Capital Medical University,Beijing 100053,China;不详)

机构地区：[1]首都医科大学宣武医院,北京市100053

出　　处：《中国病案》2024年第11期84-88,共5页Chinese Medical Record

基　　金：国家重点研发计划重大慢性非传染性疾病防控研究重点专项资助项目(2016YFC1300800)。

摘　　要：目的探讨血流导向装置植入动脉瘤患者术后并发症的原因、护理观察要点以及应对流程。方法从病案系统收集2020年1月1日-2023年9月30日某三甲医院某科实施Pipeline装置植入的661例颅内动脉瘤患者的病案资料,对行Pipeline装置植入术术后发生并发症的24例患者,共同分析并发症发生的原因,通过原因的归纳,总结不同并发症的护理观察要点及应对流程。结果661位Pipeline装置植入术的患者中24例患者发生并发症,并发症的发生率为3.63%,1例脑出血,11例脑缺血,2例脑血管痉挛,4例外周血管并发症,6例占位效应及炎性反应。24例并发症患者中6例术后出现意识障碍,7例术后出现语言障碍,11例术后出现肢体活动障碍,4例术后出现穿刺部位假性动脉瘤,皮下血肿,6例术后出现占位效应及炎性反应。RANKIN量表评分结果显示,661位患者中0分648例,1分10例,2分1例,3分0例,4分2例,5分0例。结论通过及时的护理观察及合理的医疗救治,可以减少患者并发症的发生,改善患者的神经功能,减少并发症发生后的危害。Objectives This study aims to explore the causes,key points of nursing observation and coping procedures of postoperative complications in patients with aneurysms implanted with blood flow guidance devices.Methods Based on the pre-established inclusion and exclusion criteria,661 patients with intracranial aneurysms who underwent Pipeline device implantation in a certain department of a tertiary hospital from January 1,2020 to September 30,2023 were selected from the medical record system as the research subjects.A total of 24 patients who had complications after Pipeline device implantation were included in the study.The causes of complications were jointly analyzed.Through the induction of causes,the key points of nursing observation and response procedures for different complications were summarized.Results In this study,out of 661 patients who underwent Pipeline device implantation,24 cases developed complications,with an incidence rate of 3.63%.There was 1 case of cerebral hemorrhage,11 cases of cerebral ischemia,2 cases of cerebral vasospasm,4 cases of peripheral vascular complications,and 6 cases of occupancy effect and inflammatory reactions.In the 24 cases of complications,6 patients experienced postoperative consciousness disturbances,7 patients had postoperative language disorders,11 patients developed postoperative motor function disorders,4 cases had pseudoaneurysms at the puncture site and subcutaneous hematomas,and 6 cases exhibited postoperative space-occupying effects and inflammatory reactions.The RANKIN scale scoring results showed that among 661 patients,648 cases scored 0 points,10 cases scored 1 point,1 case scored 2 points,0 cases scored 3 points,2 cases scored 4 points,and 0 cases scored 5 points.Conclusions Through timely nursing observation and appropriate medical treatment,the occurrence of complications can be reduced,the neurological function of patients can be improved,and the harm after the occurrence of complications can be minimized.

关 键 词：血流导向装置植入术 动脉瘤 并发症 护理观察与应对 

分 类 号：R473.6[医药卫生—护理学]