精细化干预措施对低分级颅内动脉瘤破裂介入栓塞术后患者的影响

Effect of refined intervention on patient with low-grade ruptured intracranial aneurysm after interventional embolization

目的探讨精细化干预措施对低分级颅内动脉瘤破裂介入栓塞术后患者的影响。方法收集2019年1月至2021年10月安徽医科大学附属安庆市第一人民医院收治的78例Hunt-Hess低分级颅内破动脉瘤裂且自发性蛛网膜下腔出血患者的临床资料,根据干预方式不同将其分为常规组(采用常规干预)和精细组(采用精细化干预),各39例。比较两组患者干预前后各项风险评估指标:采用早期预警评分系统(MEWS)评估患者的病情进展风险;采用Caprini血栓危险因素评估表评估下肢深静脉血栓(LDVT)的发生风险;采用管道滑脱危险因素评估表评估管道滑脱危险;采用Braden压疮风险评估量表评估压疮形成的发生风险;采用Morse跌倒风险评估量表评估患者住院期间跌倒的发生风险;采用患者健康教育评价表评价患者对健康知识及对疾病认知程度的掌握情况及健康教育的效果;采用日常生活能力(ADL)评定量表评估日常生活能力。采用视觉模拟评分法(VAS)评估疼痛程度。比较两组患者出院前LDVT及其他并发症的发生情况。结果干预后,精细组患者的MEWS、Caprini血栓危险因素评估表、管道滑脱危险因素评估表、Morse跌倒风险评估量表评分均明显低于常规组患者,Braden压疮风险评估量表评分明显高于常规组患者(P<0.01)。干预后,精细组患者的VAS评分低于常规组患者,ADL评分高于常规组患者,外科住院患者健康教育评价表中的各项评分均高于常规组患者(P<0.05)。精细组患者术后并发症的总发生率低于常规组患者(P<0.05)。结论精细化干预措施能够进一步降低Hunt-Hess低分级颅内动脉瘤破裂患者的临床风险与术后LDVT等并发症的发生率,减轻患者术后疼痛程度,全面改善患者的生活质量。

Objective To investigate the effect of refined intervention on postoperative complications in patients with low-grade ruptured intracranial aneurysm.Method The clinical data of 78 Hunt-Hess low-grade patients with ruptured intracranial aneurysm admitted to Anqing First People's Hospital of Anhui Medical University from January 2019 to October 2021 were collected,according to different intervention methods,they were divided into routine group(routine intervention)and refined group(refined intervention),with 39 cases in each group.The risk assessment indexes before and after the intervention were compared between the two groups:modified early warning score(MEWS)was used to assess the risk of disease progression;the risk of lower extremity deep vein thrombosis(LDVT)was assessed by using the Caprini thrombotic risk factor assessment scale;use the pipeline slippage risk factor assessment scale to assess the pipeline slippage risk;Braden pressure ulcer risk assessment scale was used to assess the risk of pressure ulcer formation;Morse fall risk assessment scale was used to assess the risk of falls in hospital;the health education evaluation form was used to evaluate the patients'mastery of health knowledge and disease cognition,as well as the effect of health education;the activity of daily living(ADL)scale was used to evaluate the activities of daily living.Visual analogue scale(VAS)was used to evaluate the degree of pain.Occurrence of LDVT and other complications were compared between the two groups before discharge.Result After intervention,the scores of MEWS,Caprini thrombotic risk factor assessment scale,pipeline slippage risk factor assessment scale and Morse fall risk assessment scale in the refined group were significantly lower than those in the routine group,and the scores of Braden pressure ulcer risk assessment scale were significantly higher than those in the routine group(P<0.01).After the intervention,the VAS scores of the refined group were lower than that of the routine group,and the ADL scores were higher than that of the routine group,and the scores in the health education evaluation form of surgical inpatients were higher than that of the routine group(P<0.05).The total incidence rate of postoperative complications in the refined group was lower than that in the routine group(P<0.05).Conclusion Refined intervention can further reduce the clinical risk degree and the incidence of postoperative LDVT and other complications in patients with low-grade Hunt-Hess intracranial ruptured aneurysm,reduce the postoperative pain degree of patients,and comprehensively improve the quality of life of patients.