超选择性动脉溶栓治疗急性脑梗死患者的护理

对16例脑梗死患者术前行充分的评估和术前准备，术后密切观察病情变化，重点做好留置溶栓导管的护理。结果闭塞血管完全或部分再通，临床症状较治疗前均有不同程度的改善。患者均治愈出院，未发生护理并发症。提示动脉溶栓具有创伤小、溶栓效果显著、并发症少的优点。手术前后认真、细致的护理时手术的成功至关重要。     

急性脑梗死患者动脉溶栓术后的早期康复护理

目的 观察早期康复护理对急性脑梗死患者动脉溶栓术后功能恢复的效果。方法将68例急性脑梗死（无严重并发症）患者随机分为康复组和对照组各34例，对照组术后按内科常规护理，康复组在此基础上予以早期康复护理，包括重症阶段术侧制动，健侧肢体按摩，主动和被动锻炼患肢和日常活动能力训练及出院前模拟出院后活动量对患者进行上下肢运动功能锻炼及生活自理能力的护理指导。观察两组平均卧床时间、住院时间、便秘发生情况及生活自理能力。结果康复组平均卧床时间、住院时间较对照组显著缩短（均P〈0．05）；便秘发生率显著低于对照组（P〈0．05）；出院前生活自理能力评分显著高于对照组（P〈0．05）。结论 急性脑梗死患者动脉溶栓术后行早期康复护理，能改善患者运动功能，缩短住院时间，提高生活质量。     

急性脑梗死患者动脉溶栓术后的早期康复护理

目的 观察早期康复护理对急性脑梗死患者动脉溶栓术后功能恢复的效果.方法 将68例急性脑梗死(无严重并发症)患者随机分为康复组和对照组各34例,对照组术后按内科常规护理,康复组在此基础上予以早期康复护理,包括重症阶段术侧制动,健侧肢体按摩,主动和被动锻炼惠肢和日常活动能力训练及出院前模拟出院后活动量对患者进行上下肢运动功能锻炼及生活自理能力的护理指导.观察两组平均卧床时间、住院时间、便秘发生情况及生活自理能力.结果 康复组平均卧床时间、住院时间较对照组显著缩短(均P＜0.05);便秘发生率显著低于对照组(P＜0.05);出院前生活自理能力评分显著高于对照组(P＜0.05).结论 急性脑梗死患者动脉溶栓术后行早期康复护理,能改善患者运动功能,缩短住院时间,提高生活质量.     

进展性脑梗死患者超早期溶栓治疗的护理

对423例进展性脑梗死（PCI）患者进行超早期溶栓治疗，溶栓前、后密切观察病情变化，减少并发症发生，并做好患者应激状态下的心理护理、并发症处理和溶栓后的早期康复护理。结果10d、30d临床疗效评定其总有效率分别为96．22％、98．11％。提示医技的密切配合、严格时间窗的选择以及护士的密切观察护理为PCI超早期溶栓治疗提供了可靠的保证。     

进展性脑梗死患者超早期溶栓治疗的护理

对423例进展性脑梗死(PCI)患者进行超早期溶栓治疗,溶栓前、后密切观察病情变化,减少并发症发生,并做好患者应激状态下的心理护理、并发症处理和溶栓后的早期康复护理.结果 10 d、30 d临床疗效评定其总有效率分别为96.22%、98.11%.提示医护技的密切配合、严格时间窗的选择以及护士的密切观察护理为PCI超早期溶栓治疗提供了可靠的保证.     

急性脑梗死动脉溶栓治疗时效分析

目的分析急性脑梗死患者不同时间的动脉内溶栓治疗效果,探讨影响治疗时间窗的因素。方法54例脑梗死患者均在CT检查及血管造影基础上接受选择性动脉溶栓治疗,其中在6h以内溶栓者42例,6~24h溶栓者12例。术后统计两组患者的血管再通率和神经功能缺失积分差值。结果两组患者治疗有效率分别为88.1%和75.0%,显效率分别为71.4%和50.0%,血管再通率分别为69.0%和50.0%,血管再通中位时间分别为68和73min。结论动脉内溶栓时间窗是与多种因素密切相关的,仅以发病时间不超过6h作为治疗标准是不够全面的,应当根据病情合理放宽溶栓的时间窗,最大降低患者的病残率,提高了患者的生活质量。     

急性脑梗死超早期静脉溶栓治疗的疗护理体会

目的:回顾性探讨急性脑梗死超早期静脉溶栓治疗的护理体会.方法:对12例急性脑梗死患者静脉溶栓前、中、后的护理.结果:对静脉溶栓前病情评估、溶栓中药物输注速度、时间、病情的观察,并发症的预防是对静脉溶栓治疗有效性评价和预后的重要保障,也是降低致残率,提高生活质量的重要举措.     

颅内动脉溶栓联合机械碎栓治疗急性脑梗死患者的护理

对9例急性脑梗死患者实施动脉内尿激酶溶栓联合机械性碎栓介入治疗。结果基本治愈5例,显效2例,有效1例,无效1例。提出超选择局域性动脉内尿激酶溶栓联合机械碎栓治疗6h内急性脑梗死,能使闭塞的血管尽快开通;建立溶栓患者绿色通道,积极为溶栓争取时间,术后严密观察病情变化,积极发现及预防并发症,做好心理护理是其护理重点。     

颅内动脉溶栓联合机械碎栓治疗急性脑梗死患者的护理

对9例急性脑梗死患者实施动脉内尿激酶溶栓联合机械性碎栓介入治疗。结果基本治愈5例,显效2例,有效1例,无效1例。提出超选择局域性动脉内尿激酶溶栓联合机械碎栓治疗6h内急性脑梗死,能使闭塞的血管尽快开通;建立溶栓患者绿色通道,积极为溶栓争取时间,术后严密观察病情变化,积极发现及预防并发症,做好心理护理是其护理重点。     

动脉内溶栓治疗36例急性缺血性脑梗死临床分析

目的探讨急性脑梗死行局部动脉内溶栓治疗的临床疗效及安全性。方法选择36例起病至溶栓时间在4～24h之内的急性缺血性脑梗死患者,经股动脉插管行全脑血管造影术发现闭塞血管后,用注射泵缓慢注射尿激酶行局部溶栓治疗,并通过导引导管造影,了解闭塞再通情况。结果36例中治愈16例,显效13例,有效6例,无效1例,显效率80.5%,总有效率97.2%。结论动脉插管接触性溶栓治疗急性脑梗死疗效确切,是治疗脑梗死有效的治疗手段。     

Preoperative Intraarterial Thrombolysis before Surgical Revascularization for Popliteal Artery Aneurysm with Acute Ischemia

Because a popliteal artery aneurysm (PAA) generates emboli that progressively deteriorate the distal arterial network, they can constitute limb-threatening lesions. In 20 to 40% of cases, discovery of PAA coincides with sudden occlusion and resulting acute ischemia. In 40 to 60% of these patients, surgical revascularization fails and amputation is required. The objective of this prospective study was to assess the value of intraarterial thrombolysis to restore distal runoff before surgical revascularization. Between January 1, 1992 and December 31, 1996, we treated 15 PAA causing acute ischemia in 15 male patients with a mean age of 66.7 years (range, 44 to 87 years). Diagnosis was documented by clinical examination and ultrasound imaging. Intraarterial thrombolysis was performed under arteriographic control through a multiperforated catheter inserted by the anterograde femoral route to the thrombus. After an initial bolus of 100,000 U of urokinase, 600,000 to 1,600,000 U was continuously infused over a period of 6 to 18 hr. Heparin sodium was administered throughout thrombolysis. Surgical revascularization was performed within 1 to 4 days (mean, 2 days) after thrombolysis by exclusion and bypass in 14 cases and percutaneous transluminal angioplasty with stenting in 1 case. The ensuing results showed that, if performed carefully, intraarterial thrombolysis can safely prepare patients presenting with occluded PAA with acute ischemia for surgical revascularization to restore distal runoff. We use this combined technique routinely in our department. Morbidity is low in comparison with the risks of amputation.     

老年急性重症卒中并发急性肺损伤的护理

对120例老年重症卒中患者行呼吸功能监测，保持呼吸道通畅，预防呼吸道感染，监测治疗原发疾病等护理干预。结果120例老年急性重症卒中并发急性肺损伤59例，无1例发展成急性呼吸窘迫综合征。提示早期施加护理干预能有效预防老年急性重症卒中并发急性肺损伤的发生。     

老年急性重症卒中并发急性肺损伤的护理

对120例老年重症卒中患者行呼吸功能监测,保持呼吸道通畅,预防呼吸道感染,监测治疗原发疾病等护理干预.结果120例老年急性重症卒中并发急性肺损伤59例,无1例发展成急性呼吸窘迫综合征.提示早期施加护理干预能有效预防老年急性重症卒中并发急性肺损伤的发生.     

Early Carotid Endarterectomy after Intravenous Thrombolysis for Acute Ischaemic Stroke

After intravenous thrombolysis (IVT) for acute ischaemic stroke (AIS), a severe cervical internal carotid artery (ICA) stenosis may remain and increase the risk of recurrent stroke. Carotid endarterectomy (CEA) has been shown to be effective in reducing the risk of stroke. However, it is not well known whether CEA can be performed safely after thrombolysis, and, if so, when. We report a prospective study of CEA for residual high-grade cervical ICA stenosis performed within 15 days after IVT for AIS.MethodsAll the patients had a brain magnetic resonance imaging (MRI) within 3 h of the stroke onset. One day after IVT in neurovascular unit, computed tomography (CT) angiography was performed to assess the brain and the patency of cervical arteries. CEA was performed on neurologically stable patients after full cerebral artery re-canalisation. Blood pressure was controlled with particular caution before and after CEA.ResultsBetween January 2005 and January 2008, we operated consecutively on 12 patients. Their median National Institutes of Health Stroke Scale (NIHSS) score was 12 (range: 5–21). Combined intracranial (ICA)–middle cerebral artery (MCA) occlusion was present in 58.3% of the patients. The median time between onset of symptoms until CEA was 8 days (range: 1–16 days). Stroke and death rate at 30 days was 8.3% (one nonfatal haemorrhagic stroke). At 90 days, nine patients had a Rankin score of 0–1, one had a score of 2 and two had a score of 3.ConclusionIn patients with residual cervical ICA stenosis after IVT, we achieved full patency of the occluded artery and good functional prognosis at 3 months in all cases. We advocate for an extremely close monitoring of the blood pressure in the pre-, peri- and post-operative course and a close collaboration between neurologist and surgeon to determine the best timing for CEA.     

婴儿急性胃扩张的护理

对9例急性胃扩张患儿进行治疗和护理,结果8例患儿治愈,1例死亡.认为胃肠减压、合理补液、心理护理和健康教育是提高治愈率的关键.