妊娠高血压综合征合并脑出血患者的护理

Care of the Patients with Gestational Hypertensive Syndrome Combined with Cerebral Hemorrhage

回顾性分析12例妊娠高血压综合征合并脑出血患者的临床资料、相应辅助检查结果,总结护理要点和体会。及早发现颅内出血、脑疝的先兆症状:头痛、头晕、呕吐、视力障碍等;通过回答问话、肢体运动和对疼痛刺激的反应掌握意识状况,定时观察瞳孔大小、差别及对光反射,一旦发现患者出现意识障碍或意识障碍加深、一侧瞳孔散大、对光反射减弱或消失、血压升高、脉搏缓慢且洪大、呼吸慢而浅,应警惕颅内出血或脑疝;密切观察其他器官出血对脑出血有预见意义,护士要熟悉每日尿常规检查、眼科检查意义,密切观察血尿、视网膜出血、反复鼻出血等出血征象;有效控制抽搐,保持患者呼吸道通畅,予高流量吸氧。精心护理是提高抢救成功率和挽救生命的关键。

By retrospectively analyzing the clinical data and results of auxiliary examinations,the author summarize her experience in caring 12 patients with gestational hypertensive syndrome combined with cerebral hemorrhage and conclude the nursing key points as follows： early finding of presynptoms of intracranial hemorrhage and cerebral hernia like headache,dizziness,vomiting,visual disorder,understanding of their consciousness conditions by question-answering,limb-acting and reacting to pains,regular observation of pupil size,difference and reaction to light.Intracranial hemorrhage and cerebral hernia can be confirmed,once consciousness disorder occurs or even develops,the pupil at one side is dilated,weak in or even not reacting to light,blood pressure goes up,pulse slows down,and respiration is slow and shallow.Close observation of other organ hemorrhage is predictive of cerebral hemorrhage.Nurses should be familiar with the implications of routine urinary examinations and ophthalmological examinations and carefully observe hemorrhage symptoms of bloody urine,retinal hemorrhage,repeated nasal hemorrhage and they should effectively manage hyperspasmia of patients,keep their respiratory tracts unobstructed and provide them with high-flow inhalation of oxygen.Elaborate care is the key to the increase of success rate in saving lives.