开颅血肿清除术术中配合常见问题调查分析及护理对策

Investigootion the common problems of intraoperative cooperation in hematoma evacuation by craniotomy and nursing countermeasures

目的：探讨开颅血肿清除术术中配合常见问题及护理对策。方法：选择2013年6月-2015年6月在我院接受开颅血肿清除术治疗的86例患者,对所有开颅血肿清除术患者术中配合常见问题资料进行汇总,对引起术后并发症的术中常见配合问题进行分析。结果：术后并发症以肺部感染最高,为33.33%,其次为应激性溃疡及再出血。经logistic回归分析,器械及物品未准备完善、医疗器械未调试、未严格执行无菌操作、未准确传递手术物品、室内温度与湿度不适宜、体位摆放不正确、术后苏醒未妥善处理、未彻底清创为开颅血肿清除术引发术后并发症的常见术中配合问题。结论：应根据常见术中配合问题积极采取相应的预防措施,以降低开颅血肿清除术中配合问题的发生率,改善患者预后。

Objective： To explore common problems of intraoperative cooperation in hematoma evacuation by craniotomy and nursing countermeasures. Methods： Selected 86 patients receiving treatment of hematoma evacuation by craniotomy in our hospital from June 2013 to June 2015,gathered all common problems and information of intraoperative cooperation of patients receiving hematoma evacuation by craniotomy,and analyzed common intraoperative cooperation problems arousing postoperative complications. Results： The pulmanory infection rate,being 33. 33%,was the highest in postoperative complications. The second one was stress ulcer and rebleeding. After logistic regression analysis,inadequate preparation for instruments and objects,unadjusted medical instruments,unstrict execution of sterile operation,inaccurate tranferring of surgical objects,improper indoor temperature and humidity,incorrect body position setting,improper handling on postoperative revival and incomplete debridement,these were all found to be common problems of intraoperative cooperation arousing postoperative complications. Conclusion： Corresponding prevention measures should be positively taken according to common intraoperative cooperation problems,so as to lower the incidence of intraoperative cooperation problems in hematoma evacuation by craniotomy and improve patient prognosis.