循证护理对颅内动脉瘤患者介入栓塞术后并发症、心理状态及预后的影响

Effects of evidence-based nursing on the psychological status and complications after interventional embolization of intracranial aneurysms

目的探讨循证护理对颅内动脉患者介入栓塞术后患者心理状态、手术并发症及短期预后的影响。方法将2012年5月-2016年5月择期行颅内动脉介入栓塞术治疗的150例患者随机分为对照组与观察组各75例，对照组采用常规护理，观察组采用循证护理，比较两组手术并发症发生率及术后脑血管痉挛发生率，比较干预前后两组SAS、SDS及格拉斯哥预后评分（GOS）的差异。结果观察组患者术后无脑血管痉挛，手术并发症发生率4．0％；对照组术后7例出现脑血管痉挛，手术并发症发生率17．3％。出院前观察组SAS（42．26±3．77）分、SDS（40．67±6．44）分，均低于对照组（t值分别为8．478、4．507；P〈0．001）。两组均无死亡病例；术后3个月，观察组GOS分级为5级患者占30．67％，对照组占13．33％，两组GOS分级比较差异有统计学意义（H=15．520，P〈0．01）。结论循证护理可降低颅内动脉瘤患者介入栓塞术后脑血管痉挛发生率，改善患者焦虑、抑郁情绪，优化其短期预后。

Objective To investigate the effects of evidence-based nursing on the psychological status, operation associated complications and short-term prognosis of patients with intracranial aneurysms after interventional embolization. Methods A total of 150 patients undergoing elective interventional embolization in the hospital from May 2012 to May 2016 were randomly divided into the control group and the observation group with 75 patients each. The control group were given routine nursing care while the observation group were given evidence-based nursing. The incidence of operation associated complications and postoperative cerebral vasospasm were compared between the two groups. The changes in scores of the Self-Rating Anxiety Scale （SAS）, Self-Rating Depression Scale （SDS）, Somatization Symptom Checklist （SCL-90） and Glasgow Outcome Scale （GOS） before and after intervention were compared. Results No postoperative cerebral vasospasm was observed in the observation group, and the incidence of operative complications was 4%. In the control group, cerebral vasospasm occurred in 7 cases, and the incidence of operative complications was 17.3%. Before discharge, SAS score （42.26 ± 3.77） and SDS score （40.67 ± 6.44） in the observation group were lower than those in the control group （t=8.478, 4.507; P 〈 0.001）. No death cases in these two groups. Three months later after operation, patients with GOS grade 5 in the observation group was 30.67%, and it was 13.33% in the control group. There was significant difference of GOS classification between the two groups （H=15.520, P 〈 0.01）. Conclusions Evidence- based nursing can help reduce the incidence of cerebral vasospasm after interventional embolization in patients with intraeranial aneurvsms, improve their anxiety and depression, and oDtimize short-term prognosis.