有症状性颈动脉狭窄患者的诱发因素分析及护理

Analysis of inducing factors and nursing care of patients with symptomatic carotid artery stenosis

目的探讨有症状性颈动脉狭窄患者症状发作的诱发因素,为预防护理提供依据。方法回顾性分析脑卒中病房2014年9月至2017年12月住院的有症状性颈动脉狭窄104例患者临床资料,对可能的诱发因素进行分析整理。结果有症状性颈动脉狭窄患者104例,无诱因发作者69例占66.3%,有诱因发作者35例占33.7%。诱发因素归纳为10类,即体位、活动与劳累、情绪、降压、进餐、饮酒、环境嘈杂、洗热水澡、大汗及寒冷刺激。有诱因患者与无诱因患者在性别、年龄、单双侧狭窄、合并症(高血压、糖尿病、冠心病、高脂血症)、是否吸烟间比较差异无统计学意义(P>0.05);有饮酒史者31例中有诱因导致疾病发作者15例占48.4%,无饮酒史者73例中有诱因导致疾病发作者20例占27.4%,两者比较差异有统计学意义(χ^2值为4.294,P<0.05)。直接因饮酒导致疾病发作者3例占8.6%。结论有症状性颈动脉狭窄患者诱发因素较多,特别是对于饮酒患者,应给予健康宣教,采取相应的预防措施以减少症状的发生。

Objective To explore the inducing factors of symptom onset in patients with symptomatic carotid artery stenosis,and to provide basis for preventive care.Methods Totally 104 patients with symptomatic carotid artery stenosis hospitalized in Stroke Ward from September 2014 to December 2017 were selected by convenience sampling method.The clinical data of patients were analyzed retrospectively,and the possible inducing factors were analyzed.Results there were 104 patients with symptomatic carotid artery stenosis,and 35 patients(33.7%)had obvious inducing factors before onset,but 69 patients(66.3%)had not.The inducing factors were classified into ten categories:posture,activity and fatigue,mood,blood pressure reduction,eating,drinking,noisy environment,hot bath,sweating and cold stimulation.There was no significant difference in gender,age,single and bilateral stenosis,comorbidities(hypertension,diabetes,coronary artery disease,hyperlipidemia)and smoking between the induced group and the non-induced group(P>0.05).Among the 31 patients with a history of alcohol consumption,15 had an inducement,accounting for 48.4%;among the 73 patients without a history of alcohol consumption,20 had an inducement,accounting for 27.4%.The difference between the two groups was statistically significant(χ^2=4.294,P<0.05).Three cases(8.6%)were directly caused by drinking alcohol.Conclusion There are many inducing factors for symptomatic carotid artery stenosis,especially for drinking patients,health education should be given,and corresponding preventive measures should be taken to reduce the occurrence of symptoms.