烟雾病颞浅动脉-大脑中动脉分流术+脑-硬脑膜-颞肌血管融通术围手术期护理

Perioperative nursing of 58 patients with moyamoya disease undergoing STA-MCA bypass surgery and EDMS

目的总结烟雾病行颞浅动脉-大脑中动脉(STA-MCA)分流术+脑-硬脑膜-颞肌血管融通术(EDMS)围手术期护理经验。方法回顾性分析2016年12月至2018年12月采用STA-MCA分流术+EDMS治疗58例烟雾病的临床资料,总结围手术期护理经验。结果58例中,3例出现脑过度灌注综合征,对症治疗2周后症状缓解;1例术后12 h出现癫痫发作;1例术后对侧肢体活动障碍,肌力Ⅲ级,经治疗后3个月复查肌力为Ⅳ级。结论烟雾病行STA-MCA分流术+EDMS治疗,加强围手术期护理,可有效提高手术效果,减少并发症。

Objective To investigate the perioperative nursing measures in the patients with moyamoya disease undergoing superficial temporal-middle cerebral artery(STA-MCA)bypass and encephaloduromyosynangiosis(EDMS)surgery.Methods The analysis of preoperative evaluation,perioperative complications,perioperative nursing measures and the clinical effect was performed in 58 patients with moyamoya disease who underwent STA-MCA bypass and EDMS surgery from December,2016 to December,2018.The emphasis was placed on effective nursing intervention for possible postoperative adverse complications including hyperperfusion syndrome,anastomotic occlusion and cerebral ischemic attack.Results Of the 58 patients,53 were recovered well and 5 had postoperative complications including 3 with cerebral hyperperfusion syndrome after the surgery in whom the syndrome symptom was relieved 1 week after the treatment,1 with epileptic seizure 12 hours after the surgery and 1 with postoperative contralateral limb activity disturbance in whom the muscle strength returned to gradeⅣ3 months after the treatment.Conclusion Strengthening perioperative nursing is very helpful to the improvement of the surgical effect and clinical symptoms,and patients quick recovery early after surgery in the patients with moyamoya disease treated with STA-MCA bypass and EDMS surgery.