脑出血微创术后继续出血危险因素分析及护理对策

RISK FACTORS ANALYSIS AND NURSING MEASURES FOR POSTOPERATIVE BLEEDING IN PATIENTS WITH HYPERTENSIVE INTRACEREBRAL HEMORRHAGE

目的探讨高血压性脑出血(intracerebral hemorrhage ICH)微创颅内血肿穿刺引流术后继续出血的危险因素及护理措施。方法 98例ICH患者中,按微创术后有无继续出血分为两组。出血组20例为继续出血者,对照组78例为无继续出血者。统计分析患者有无饮酒史、术前血压、脑出血的部位、原发出血量、出血到微创手术的时间、穿刺部位、术后血压控制情况等临床资料。结果微创颅内血肿穿刺术后继续出血与手术时间、术前血压增高、手术前后躁动、长期酗酒、血肿形态不规则等有关(P<0.05)。结论酗酒、术前高血压、脑出血的形态、手术时间及患者躁动是引起术后继续出血的危险因素,应采取有效的具有针对性的护理对策。

Objective To explore the risk factors of postoperative bleeding and nursing measures after the puncture drainage of intracranial hematoma in patients with hypertensive intracerebral hemorrhage （HICH）. Methods 98 cases of HICH were randomly divided into the postoperative bleeding group of 20 cases and the non-bleeding group of 78 cases. The clinical data of patients; drinking history, the preoperative blood pressure, the site of cerebral hemorrhage parts, primary bleeding volume, the continuous bleeding until minimally invasive surgery, the site of puncture and the postoperative control of blood pressure were analyzed. Results The postoperative continuous bleeding after the puncture drainage of intracranial hematoma in patients was closely related to the operative time, the preoperative increase in blood pressure, the preoperative and postoperative restlessness, long-time alcohol addiction and the irregularity of hematoma（P〈0.05）. Conclusion The risk factors of postoperative bleeding in patients with HICH are mainly alcohol addiction, preoperative high blood pressure, the form of hematoma, operative time and restlessness. Effective nursing measures should be taken to treat HICH.