双腔管治疗高血压脑出血的护理干预措施研究

Research on Nursing Intervention Measures of Double-lumen Tubes in Treatment of Hypertensive Cerebral Hemorrhage

目的探讨护理干预措施对双腔管冲洗引流并尿激酶溶解治疗高血压脑出血的影响。方法方便选取2014年5月—2016年6月该院行双腔管冲洗引流并尿激酶溶解术治疗的高血压脑出血患者122例,将符合标准的入选患者随机分为治疗组(61例)和对照组(61例),治疗组患者在给予常规护理的基础上增加以下护理措施:(1)控制冲洗液温度为亚低温(32~34℃);(2)冲洗时快速挤压双腔管;(3)三通开关一端使用肝素帽封闭。观察两组患者颅内血肿清除时间、带管时间及颅内积气、感染、再出血并发症的发生率。结果治疗组中4例、对照组中5例患者因资料不完整被删除。治疗组患者48 h内血肿清除或残余血肿量<5 m L比率高于对照组(治疗组44例;对照组31例),平均带管时间少于对照组[(治疗组(56.82±22.16)h;对照组(66.18±24.62)h],差异有统计学意义;治疗组颅内积气或感染发生率低于对照组(治疗组3例次;对照组10例次),差异有统计学意义(P<0.05);两组患者再出血发生率(治疗组6例次;对照组5例次)差异无统计学意义(P>0.05)。结论控制冲洗液温度为亚低温、冲洗时快速挤压双腔管、三通开关一端用肝素帽封闭护理干预措施能更有效清除脑内血肿并减少并发症。

Objective To study the effect of nursing intervention measures on the double-lumen tubes washing and drainage and urokinase in treatment of hypertensive cerebral hemorrhage. Methods 122 cases of hypertensive cerebral hemorrhage patients with the double-lumen tubes washing and drainage and urokinase in our hospital from May 2014 to June 2016 were convenient selected and randomly divided into two groups with 61 cases in each, the treatment group adopted the nursing measures on the basis of the routine nursing as follows:(1)control the flushing fluid temperature subhypothermia(32~34℃).(2)rapid extrusion of double-lumen tubes at washing.(3)Using the heparin cap to close one end of three-way cock, and the clearance time of intracranial hematoma, tube time and incidence rates of intracranial pneumatocele, infection and rebleeding complications of the two groups were observed. Results 4 cases in the treatment group and 5 cases in the control group were deleted due to incomplete data, and the evacuation of hematoma or residual hematoma volume <5 m L in 48 h in the treatment group was higher than that in the control group,(44 cases in the treatment group and 31 cases in the control group), and the average tube time was less than that in the control group [(56.82±22.16)h in the treatment group;(66.18±24.62)h in the control group)], and the difference was statistically significant(P <0.05), the incidence rate of intracranial pneumatocele and infection in the treatment group was lower than that in the control group,(3 cases in the treatment group and 10 cases in the control group), and the difference was statistically significant, and the difference in the incidence rate of rebleeding between the two groups was not statistically significant,(6 cases in the treatment group and 5 cases in the control group)(P>0.05). Conclusion The nursing intervention measures of controlling the flushing fluid temperature subhypothermia, rapid extrusion of double-lumen tubes at washing and using the heparin cap to close one end of three-way cock can effectively clear the intracerebral hematoma and reduce the complications.