外伤性脑动脉瘤患儿病情观察与护理

Observation and nursing of children with traumatic cerebral aneurysm

通过对收治的4例外伤性脑动脉瘤患儿病情观察及护理,进行回顾性经验总结。本组病例提示,脑表面和颅底的外伤性脑动脉瘤多由于颅骨骨折直接损伤血管所致。外伤所致的脑深部动脉瘤,是由于脑血管与大脑镰等结构撞击所致。表现为颅脑损伤症状好转后2周或更长时间,病情突然恶化。因此儿童颅脑损伤经对症治疗,伤后病情虽趋于稳定,护理中仍不能忽略持续的意识观察。一旦病人出现头痛、呕吐等颅内压增高症状,腰穿显示血性脑脊液时,警惕外伤性脑动脉瘤。护理中密切观察病情,避免颅内压骤然增高,做好脑室引流护理。

We performed a retrospective summary about the observation and nursing of4children with traumatic cerebral aneurysm admitted into our department,finding that cerebral superficial and skull base aneurysms were caused by injury of the blood vessels from fracture of cranial bone while deep cerebral aneurysms by traumatic hit on cerebral blood vessels and cerebral falx.2weeks or more after elimination of the symptoms of craniocerebral injuries,it abruptly deteriorated.Therefore,although the infants tend to recovery after expectant therapy of craniocerebral injuries,we cannot neglect the observation of their consciousness.Once such symptoms of intracranial hypertension as headache and vomiting occur and lumbus puncture shows bloody cerebrospinal fluid,we should take it as traumatic cerebral aneurysm.In nursing,close observation of the disease and avoidance of abrupt increase of intracerebral hypertension and cerebral drainage nursing are vital.