MIA开颅夹闭术围术期护理研究

Perioperative nursing study of MIA intracranial aneurysm clipping craniotomy

目的:掌握多发性颅内动脉瘤(MIA)开颅夹闭术围手术期的护理技巧,促进患者康复。方法:收集36例使用开颅夹闭术治疗MIA患者的临床资料、术中配合及术后监护、随访体会等资料并进行分类、分析、总结。结果:患者开颅夹闭术中均成功夹闭动脉瘤,其中有1例患者行介入栓塞术失败后转变为开颅夹闭治疗,2例患者分2次手术进行夹闭。格拉斯哥预后评分(GOS)评估36名患者随访3~40个月后预后,GOS4~5级有20例(55.6%),GOS1~3级有16例(44.4%),随访过程中有4名患者(11.1%)死亡。结论:开颅夹闭术治疗多发性颅内动脉瘤在技术上具有较高的挑战性,术中动脉瘤破裂和术后并发症发生率均较高;做好专业的围术期护理能够有效地减少动脉瘤术中破裂风险及术后并发症。

Objective:Master the perioperative nursing skills of multiple intracranial aneurysms(MIA)intracranial aneurysm clippingcraniotomy and promote rehabilitation.Methods:36 cases of MIA intracranial aneurysm clipping craniotomy patients were selected as the research objects.The clinical data,intraoperative cooperation,postoperative monitoring and follow-up experience of these patients were collected and classified,analyzed and summarized.Results:In these patients,the aneurysms were successfully clipped during craniotomy.However,one of the patients was converted to craniotomy after failure of interventional embolization,and two patients were clipped with two operations.Glasgow Outcome Score(GOS)evaluated 36 patients with a follow-up of 3~40 months,20(55.6%)with GOS4~5,16(44.4%)with GOS1~3,and 4(11.1%)patients died during follow-up.Conclusion:Intracranial aneurysm clipping craniotomy for the treatment of multiple intracranial aneurysms is technically challenging.The incidence of intraoperative aneurysm rupture and postoperative complications is high.Professional perioperative care can be effectively reduced the risk of intraoperative rupture of aneurysms and postoperative complications.