颅内动脉瘤栓塞术围手术期护理策略及术中瘤体破裂的护理配合

目的探讨颅内动脉瘤行MicroPlex弹簧圈系统(MCS)栓塞术的围手术期护理策略及术中瘤体破裂的护理配合。方法回顾分析行MCS栓塞术的64例颅内动脉瘤患者临床资料(其中4例患者术中发生瘤体破裂),动脉瘤位于前交通动脉23例,后交通动脉17例,大脑前动脉14例,大脑中动脉9例,左颈内动脉1例。结果术中瘤体破裂4例,仍继续施行MCS栓塞术,其中3例获得治愈,1例因术后并发脑梗塞死亡。治愈63例,均获随访,平均6(3~24)月,均未见并发症发生。结论术前健康宣教,术中积极配合,术后密切观察病情,对减少颅内动脉瘤并发症的发生以及帮助病人顺利度过围手术期均具有十分重要的作用。

Experience of Perioperative Nursing Strategy of Intracranial Aneurysm and Nursing Cooperation of Aneurysmal Rupture during Embolization

Objective To study the perioperative nursing experience of intracranial aneurysm and nursing cooperation of aneurismal rupture during treatment with MCS embolization.Methods 64 cases of intracranial aneurysms performed MCS embolization were analyzed retrospectively,in which 4 cases occurred aneurismal rupture during embolization.The aneurysm was located at anterior communicating artery in 23 cases,posterior communicating artery in 17 cases,anterior cerebral artery in 14 cases,middle cerebral artery in 9 cases and left internal carotid artery in 1 case.Results 4 cases occurred aneurismal rupture during the treatment,and then continued embolization with MCS.Among them,3 cases were cured and 1 case died of postoperative complication of brain infarction.63 cases were cured without postoperative complication during 3 to 24 months follow-up.Conclusion The measures of preoperative sufficient health propaganda and education,intraoperative proactive cooperation and postoperative intimate observation can reduce the complication rate of intracranial aneurysm and ensure the safety of perioperative period.