摘要
总结200例成人缺血型烟雾病患者行脑—硬膜—动脉血管融通术(encephalo-duro-arterio synangiosis,EDAS)共312例次的护理。术前注重患者的心理护理,保证睡眠质量,避免术前过度紧张影响手术;术后严密观察病情变化,警惕颅内出血,并按时调整患者的体位,指导其行适当活动,促进康复;做好缺血性发作、切口感染、皮下积血、颜面部水肿等并发症的预防及护理;重视出院指导,告知患者注意保护头部,避免术区受压。本组患者术中并发大面积脑梗死2例,术后并发缺血性发作28例,皮下积液32例,颜面部水肿39例。本组患者均痊愈出院,未出现感染及死亡病例。所有病例均通过电话随访,172例症状明显缓解,28例无明显变化,16例再发缺血症状。125例术后3个月复查PET-CT,106例脑原代谢减低区明显改善,19例无明显改善。70例术后3～20个月复查全脑血管造影(digital subtraction angiography,DSA),良40例,一般23例,差7例。
This paper is to summarize nursing of 200 adult patients with moyamoya undergoing EDAS （encephalo-duro-arterio synangiosis）, altogether 312 cases pre- and post-operation. Psychological care and preoperative education were conducted, while after operation, close monitoring, activities guidance, complications prevention and discharge guidance were enforced. The complications occurred in this group were massive cerebral infarction in 2 cases in the operation and postoperative ischemie attacked 28 cases, 32 cases of subcutaneous fluid, facial edema in 39 cases. All the patients were discharged without any infection and death. Through retrospective investigation by phone, 172 patients were relieved obviously and no significant changes in 28 patients, 16 patients of recurrent ischemic symptoms. 125 patients were reviewed PET-CT after 3 months, cerebral metabolic of 106 patients showed significant improvement of the original ischemic areas, 19 patients without improvement. 70 patients were checked by DSA after 3 to 20 months later, good in 40 patients, 23 of normal, and poor in 7 patients.
出处
《护理学报》
2010年第12期34-36,共3页
Journal of Nursing（China）
