微创引流加尿激酶治疗高血压脑出血患者的护理对策

Nursing strategy for minimally invasive drainage combined with urokinase in the treatment of hypertensive intracerebral hemorrhage

目的评价微创引流加尿激酶治疗高血压脑出血(Hypertensive intracerebral hemorrhage,HICH)效果,总结护理经验。方法 2012年2月至2015年5月,医院共以微创引流加尿激酶治疗HICH98例。结果术后即刻颅内压低于术前,14日后颅内压、ME-S评分低于术前,血肿清除率、ME-S低于术后即刻,差异具有统计学意义(P<0.05);14日后,好转41例、无变化32例、恶化21例、死亡4例;好转组再出血、肺部感染率低于对照组,差异具有统计学意义(P<0.05)。结论微创引流加尿激酶清除血肿效果好,再出血等并发症已成为HICH患者预后不佳的主要原因,需做好并发症管理。

Objective To evaluate the treatment effect of treating hypertensive intracerebral hemorrhage （HICH） by minimally invasive drainage with urokinase, in order to summarize nursing experience. Methods 98 cases with HICH were given minimally invasive drainage combined with urokinase in our hospital during February 2012 and May 2015. Results Immediate postoperative intracranial pressure was lower than that before operation, 14 days postoperative intracranial pressure, the ME - S score was lower than the preoperative and hematoma clearance rate, the ME -S was lower than the immediate postoperative intracranial pressure, the ME -S score, the difference was statistically significant （P 〈 0. 05）. 14 days postoperative, 41 cases taken a turn to the better, no change in 32 cases, 21 cases getting worse and 4 cases died. Rehaemorrhagia and lung infection rate of relapse group was lower than the control group, the difference was statistically significant （P 〈 0. 05 ）. Conclusions Minimally invasive drainage combined with urokinase has a good effect in clearing hematoma, more complications such as bleeding has become the main cause of poor prognosis of patients with HICH, we need to make better management of the complications.