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目的探讨避免颅内动脉瘤手术麻醉诱导期破裂的护理方法。方法回顾性分析2012年10月-2013年10月收治的428例颅内动脉瘤患者麻醉诱导期间护理方法。根据颅内动脉瘤破裂诱因:忧虑、紧张、激动、血压忽然升高、体力劳动,采取护理措施避免诱因导致颅内动脉瘤在麻醉诱导期破裂,并根据患者的具体情况实施有针对性的麻醉诱导期护理。结果 428例颅内动脉瘤患者麻醉诱导期间均未出现颅内动脉瘤破裂出血,有2例患者麻醉诱导期间收缩压下降绝对值<80 mm Hg(1 mm Hg=0.133 k Pa),其余患者麻醉诱导后生命体征均在正常范围;术中颅内动脉瘤破裂出血3例。患者出院时预后良好者385例,预后差者39例,死亡4例。结论在麻醉诱导期根据颅内动脉瘤破裂诱因及患者的具体情况采取护理措施,能够有效控制其情绪,稳定麻醉诱导期血流动力学的波动,对减少术中动脉瘤破裂出血,提高颅内动脉瘤破裂夹闭手术治疗效果,减少并发症的发生及患者的预后有帮助。
Objective To explore the nursing method to avoid the rupture during induction of intracranial aneurysm surgery. Methods A retrospective analysis of 428 patients with intracranial aneurysm admitted to our hospital from October 2012 to October 2013 was performed during anesthesia induction. According to the causes of intracranial aneurysm rupture: anxiety, tension, excitement, sudden increase in blood pressure, manual labor, to take care of incentives to avoid causes of intracranial aneurysm rupture induced during anesthesia, and according to the specific circumstances of patients with targeted anesthesia Induction care. Results No intracranial aneurysm rupture occurred in 428 patients with intracranial aneurysm during anesthesia induction. The absolute value of systolic blood pressure drop was <80 mm Hg (1 mm Hg = 0.133 kPa) during anesthesia induction in 2 patients, and the rest were anesthetized After the induction of vital signs are in the normal range; intraoperative intracranial aneurysm rupture in 3 cases. 385 patients with good prognosis at discharge, 39 patients with poor prognosis, 4 patients died. Conclusion The induction of anesthesia according to the causes of intracranial aneurysm rupture and the specific circumstances of patients to take care of the measures can effectively control their emotions and stabilize the induction of haemodynamic fluctuations during anesthesia to reduce intraoperative rupture of aneurysm bleeding and improve intracranial Aneurysm rupture occlusion surgery to reduce the incidence of complications and the prognosis of patients helpful.