置管溶解引流血肿治疗高血压脑出血372例临床护理分析

Chinical nursing of catheter drainage of hematoma dissolving in hypertensive cerebral hemorrhage:on 372 cases report

目的探讨高血压脑出血血肿置管引流溶解术的临床护理。方法对372例高血压脑出血患者在手术治疗的基础上进行手术前后的护理,观察治疗效果。结果 372例高血压壳核、丘脑、脑干出血等经CT定位及钻孔冲洗引流术后患者,置管注入尿激酶10000U+5ml生理盐水于血肿腔,3h后开放引流,每天3次。并注意引流管及术后并发症护理。其中死亡90例(病死率为24.2%),282例存活者中日常生活活动能力(ADL)2以上者占67.0%。结论尿激酶是目前国内用于高血压脑出血溶解的最佳药物。加强高血压脑出血患者外科手术前后的护理是提高引流溶解血肿的关键。

Objective To discuss the nursing method of catheter drainage of hematoma dissolving in hypertensive cerebral hemorrhage.Methods 372 cases patients of cerebral hemorrhage in the surgical treatment of based on nursing were researched before and after surgery.Results After CT positioning,drilling,flush and drainage,the hypertensive cerebral hemorrhage patients positioninged in crust-nucleus,the thalamus,and brainstem were injected urokinase 10,000 U and normal saline 5ml into hematoma cavity.And after 3 hours,they were open drainaged,3 times per day.90 patients of 372 hypertensive cerebral hemorrhage patients were die（the mortality was 24.2%）,in the 282 patients survived,above ADL2 were 67.0%.Conclusion Urokinase is the best hemolysis drugs which treatment hypertensive cerebral hemorrhage.Strengthening of hypertensive cerebral hemorrhage before and after surgery care is the key of improving the drainage of hematoma dissolving.