延续护理对颅内动脉瘤致蛛网膜下腔出血介入填塞术后脑积水预后的影响

Effect of continuous nursing on hydrocephalus after interventional tamponade for subarachnoid hemorrhage caused by intracranial aneurysm

目的总结延续护理对颅内动脉瘤致蛛网膜下腔出血介入填塞术后脑积水预后的影响,从脑积水康复和并发症角度探索延续护理方法。方法回顾性分析2017-01—2020-06颅内动脉瘤致蛛网膜下腔出血介入填塞术后脑积水31例实施延续护理患者(延续组)的临床资料,同期33例未进行延续护理患者为对照组,对患者进行随访,观察其脑积水恢复、复发和并发症情况。结果出院随访延续组GOS分级Ⅲ级2例,Ⅳ级6例,Ⅴ级23例;对照组GOS分级Ⅲ级5例,Ⅳ级10例,Ⅴ级18例,分流复发及并发症死亡2例,2组差异有统计学意义(P<0.05)。延续组出现3例脑积水腹腔分流复发,对照组4例,2组差异无统计学意义(P>0.05)。延续组分流并发症1例,对照组5例,其中2例死亡,2组差异有统计学意义(P<0.05)。结论颅内动脉瘤致蛛网膜下腔出血介入填塞术后脑积水患者出院后延续护理有助于患者康复并及时发现脑积水复发和并发症。

Objective To summarize the effect of continuous nursing on the prognosis of hydrocephalus after interventional tamponade of subarachnoid hemorrhage caused by intracranial aneurysm,and to explore the methods of transitional care.Methods A retrospective descriptive method was used to analyze 31 patients with hydrocephalus after interventional tamponade of subarachnoid hemorrhage caused by intracranial aneurysm from January2017 to June 2020(continued group),and 33 patients who did not receive continued care during the same period in the control group,the patients were followed up,and the recovery of hydrocephalus,recurrence and complications were observed.Results In the research group,there were 2 cases of GOS gradeⅢ,6 cases of GOS gradeⅣand 23 cases of GOS gradeⅤ.In the control group,there were 5 cases of GOS gradeⅢ,10 cases of GOS gradeⅣand 18 cases of GOS gradeⅤ,and 2 cases of shunt recurrence and complication death.There was significant difference between the two groups(P<0.05).Recurrence of intraperitoneal shunt of hydrocephalus occurred in 3 cases in the research group and 4 cases in the control group.There was no significant difference between the two groups(P>0.05).Shunt complications occurred in 1 case in the research group and 5 cases in the control group,of which 1 case and 2 cases died.There was significant difference between the two groups(P<0.05).Conclusion Transitional care after discharge of hydrocephalus patients with subarachnoid hemorrhage caused by intracranial aneurysms after interventional packing is helpful to recover and find the recurrence and complications of hydrocephalus in time.