综合干预在烟雾病患者行颞浅动脉-大脑中动脉搭桥术围术期的应用效果

Effects of comprehensive nursing intervention in patients with MMD receiving middle cerebral artery bypass surgery for perioperative superficial temporal artery

目的探讨围术期综合护理干预对行颞浅动脉-大脑中动脉搭桥手术治疗的烟雾病患者手术效果及远期生活质量的影响。方法选取2017年12月至2019年12月收治的烟雾病患者86例,所有患者行颞浅动脉-大脑中动脉搭桥手术治疗,随机分为研究组与对照组,每组43例。对照组实施常规护理干预,在常规护理基础上,研究组实施围术期综合护理干预。比较2组患者的脑血流动力学(相对脑血容量、相对脑血流量、相对达峰时间、相对平均时间)变化、自护能力及远期生活质量。结果对照组的治疗总有效率为46.51%,显著低于研究组的69.77%,差异有统计学意义(P<0.05)。术后6个月时,对照组患者的相对脑血容量、相对脑血流量均较术前增高,相对达峰时间与相对平均时间则降低,且研究组患者的以上指标改善情况均优于对照组,差异有统计学意义(P<0.05)。研究组患者的健康知识水平、自我护理概念、自我护理责任感、自我护理技能及自护总分均高于对照组,差异有统计学意义(P<0.05)。研究组患者的KPS评分高于对照组,且研究组中评分>60分例数高于对照组,差异有统计学意义(P<0.05)。结论对行颞浅动脉-大脑中动脉搭桥手术治疗者实施围术期综合护理干预,有助于改善患者脑部血液循环,增强去自护意识,提高临床治疗效果及远期生活质量。

Objective To explore the effects of perioperative comprehensive nursing intervention on surgical effects and long-term quality of life of patients with moyamoya disease(MMD)receiving middle cerebral artery bypass surgery for superficial temporal artery.Methods From December 2017 to December 2019,86 patients with MMD were selected,all the patients were managed middle cerebral artery bypass graft surgery for superficial temporal artery,and were randomly divided into the study group and control group with 43 cases in each group.the study group received perioperative comprehensive nursing intervention on the basis of routine nursing.Changes in cerebral hemodynamics(relative cerebral blood volume,relative cerebral blood flow,relative peak time,relative average time),self-care ability and long-term quality of life of patients in two groups were compared.Results The overall response rate of patients in the control group was significantly lower than that of patients in the study group(46.51%vs 69.77%,P<0.05,respectively).Compared with before treatment,the increased relative cerebral blood volume and the relative cerebral blood flow,and the decreased relative peak time and relative average time were detected in the control group on the 6th month of post-operation.The improvements of the above indicators in the study group were significantly better than those of patients in the control group(P<0.05).The health knowledge level,self-care concept self-care awareness of responsibility,self-care skills and total self-care scores in the study group were statistically higher than those in the control group(P<0.05).KPS scores in the study group were higher than those in the control group,the number of cases with scores above 60 points in the study group was higher than that of cases in the control group,and the differences were statistically significant(P<0.05).Conclusion The perioperative comprehensive nursing intervention implemented for patients receiving middle cerebral artery bypass surgery for superficial temporal artery makes for improving the cerebral blood circulation,intensifying self-care awareness,and improving clinical treatment effects and long-term quality of life.