1例小脑后下动脉瘤术后并发气道塌陷患者的护理

Nursing care of a patient with airway collapse after posterior lower cerebellar aneurism surgery

小脑后下动脉瘤属于后循环动脉瘤之一,包括从小脑后下动脉和椎动脉交界处发出的动脉所产生的动脉瘤,位置毗邻脑干和后组颅神经,瘤体多为非囊状。小脑后下动脉瘤的发生率低,由于特殊的解剖位置及瘤体形态,导致手术治疗难度较大,术后易产生多种严重并发症。临床上常见的手术治疗方式有开颅动脉瘤夹闭术、单纯血管内介入栓塞治疗、血管搭桥术。文章总结1例小脑后下动脉瘤介入栓塞术后并发气道塌陷患者的护理,主要包括气道塌陷高风险识别、气道塌陷的疾病观察及紧急抢救、气道置管期间集束化气道管理、术后拔除气管插管前的评估及护理、气管插管拔管后预见性护理及观察。患者经过积极的抢救和护理,病情好转,转康复医院继续治疗。

The posterior inferior cerebellar aneurysm is one of the posterior circulation aneurysms,including the aneurysm produced by the artery emanating from the junction of the posterior inferior cerebellar artery and the vertebral artery.The location is adjacent to the brain stem and the posterior group of cranial nerves,and the tumor body is mostly non-saccular.The incidence of posterior inferior cerebellar aneurysms is low,because of the special anatomical location and tumor morphology,it is difficult to operate,and it is easy to produce many serious complications after surgery.The common surgical treatment methods in clinic include craniotomy aneurysm clipping,simple endovascular interventional embolization,and vascular bypass.The article summarizes the nursing care of a patient with airway collapse after interventional embolization of posterior inferior cerebellar aneurysms,which mainly includes high-risk identification of airway collapse,disease observation and emergency rescue of airway collapse,cluster airway management during airway tube placement,evaluation and nursing before postoperative tracheal intubation,and predictive nursing and observation after tracheal intubation and extubation.After active rescue and nursing,the patient's condition improved and was transferred to a rehabilitation hospital for continued treatment.