动脉瘤性蛛网膜下腔出血患者迟发性缺血性神经功能障碍的临床.docVIP

动脉瘤性蛛网膜下腔出血患者迟发性缺血性神经功能障碍的临床特点及护理 郭小叶1，赵淑敏2，贺慧兰1，吴媛媛1，白岗1，周红1 (西安交通大学医学院第一附属医院 1.神经外科；2.护理部 陕西 西安 710061） [摘要目的 探讨动脉瘤性蛛网膜下腔出血（SAH)）后迟性缺血性神经功能障碍（DIND）的临床特点及。方法SAH后发生DIND的患者随机分为观察组24例和对照组18例，观察组在常规治疗及护理的基础上根据DIND的临床特点采取有针对性的护理措施，对照组按常规进行治疗及护理。比较两组患者并发症发生情况，患者舒适度、满意度、平均住院日、健康教育及护理措施有效率等。结果 全组例均被诊断为DIND。治疗结果根据Glasgow预后评分：Ⅰ级例，Ⅱ级例，Ⅲ级例，Ⅳ级例，Ⅴ级例；死亡率1.05%；观察组患者并发症发生率较低，护理措施有效率及护理满意度明显提高。结论SAH后DIND的形成由多个因素造成，其预后与这些因素密切相关；根据临床特点对该病采取有针对性的护理措施可有效改善预后。 [关键词 颅内动脉瘤；蛛网膜下腔出血；迟性缺血性神经功能障碍；Clinical features and evidence based nursing of delayed ischemic neurological deficits in aneurismal subarachnoid hemorrhage GUO Xiaoye，ZHAO Shu-min，HE Huilan，WU Yuan-yuan，BAI Gang，ZHOU Hong (Department of Neurosurgery,the First Affiliated Hospital, Medical School of Xian Jiaotong University,Xian,710061,China) Abstract: Objective To discuss the clinical features and nursing projects of delayed ischemic neurological deficits (DIND) in patients with aneurismal subarachnoid hemorrhage (aSAH). Methods 42 patients with DIND after aSAH were divided into two groups: experimental group, who were treated with a particular nursing project， and control group randomly. Clinical features including complication development, efficiency of nursing intervention and degree of satisfaction of nursing were analyzed and compared between the two groups. Results All the 42 patients involved in this study were diagnosed DIND. According to the Glasgow outcome score (GOS), the outcome of these patients was classified into 5 grades: 7 patients for grade Ⅰ, 13 cases for grade Ⅱ, 12 cases for grade Ⅲ, 2 cases for grade Ⅳ, and 8 cases for grade Ⅴ. The mortality rate was 19.05%. Compared with the control group, incidence of complications in experimental group was much lower while efficiency of nursing intervention and degree of satisfaction of nursing was [基金项目] 陕西省“13115”科技创新工程重大科技专项计划资助项目（2008ZDKG-66） [作者简介] 郭小叶(1976-),女，陕西西安人，学士，硕士在读，护士长 higher. Conclusions The formation of DIND after aSAH was caused by many factors which were