心胸外科糖尿病患者围术期护理

目的:探讨心胸外科糖尿病患者围手术期的临床相关护理措施。方法:对我院2008年7月~2009年3月60例心胸外科糖尿病患者围手术期的临床相关护理资料予以回顾性的分析总结。结果:通过3周临床治疗及相关护理干预措施,60例心胸外科糖尿病手术患者中,有1例存在肺部感染,2例出现手术切口裂开,通过采取及时有效的治疗及护理措施,患者均痊愈出院,无死亡病例。结论:采取积极有效的临床相关护理措施对心胸外科糖尿病患者进行围手术期护理干预,可以较好的提高患者的临床治疗效果,值得临床借鉴应用。     

外伤性癫痫25例手术治疗的护理

目的:探讨外伤性癫痫手术治疗的临床观察及护理要点。方法:25例外伤性癫痫患者行手术治疗,术前进行充分的心理护理及术前准备;术后严密观察病情,着重加强安全保护措施及癫痫发作的监测及护理;强化康复护理指导、生活环境饮食指导、用药指导等健康指导。结果:术后半年以上随访,18例患者疗效满意,2例疗效显著,1例效果良好,4例效果较差,本组患者的有效率为84%(21/25)。结论:外伤性癫痫是顽固性癫痫中手术疗效较好的一种类型,其术前心理护理及完善的术前准备是手术治疗的基础护理措施,术后的病情观察及细致的护理是关键,健康指导对确保手术疗效、促进康复起着重要的作用。     

顽固性癫痫持续状态的临床用药观察与护理

目的 探讨外伤性顽固性癫痫持续状态患者使用大剂量抗癫痫药物的用药观察和临床护理.方法 回顾分析5例重症顽固性癫痫持续状态病例.结果 5例患者癫痫均有效控制,4例康复出院,1例持续深昏迷,意识状态未恢复家属自动出院.结论 严密的病情观察,细致的用药护理,预防各类并发症,是顽固性癫痫持续状态护理的关键.     

多元化延续护理对大脑半球萎缩继发癫痫患者的影响

目的:探讨多元化延续护理对大脑半球萎缩继发癫痫患者日常生活能力、依从性和护理满意度的影响。方法:选取我院2012年3月~2014年3月大脑半球萎缩继发癫痫行手术切除患者20例作为研究对象,采取多元化延续护理措施,观察比较多元化延续护理前后对患者日常生活能力、依从性和护理满意度的影响。结果:出院12个月后,患者在日常生活能力、依从性和护理满意度方面与出院时比较有统计学差异(P0.05)。结论:对大脑半球萎缩继发癫痫患者进行多元化延续护理干预,有利于提高患者的自理能力、依从性和对护理工作的满意度。     

大剂量呋塞米联合高渗盐水治疗顽固性心力衰竭24例临床护理

目的:探讨大剂量呋塞米加高渗盐水治疗顽固性心力衰竭的临床疗效及护理方法.方法:将48例顽固性心力衰竭患者采用随机数字表法将其分为治疗组和对照组各24例,两组均采取心理护理、密切观察用药情况、严格卧床休息等综合护理措施,治疗组在此基础上静滴大剂量呋塞米加高渗盐水治疗;对照组静滴呋塞米,不加高渗盐水,分析比较两组的治疗效果.结果: 治疗组显效11例,有效8例,无效5例(包括死亡2例),总有效率79.17%;对照组显效5例,有效7例,无效12例(包括死亡4例),总有效率50%,两组比较差异有统计学意义(χ2=4.46,P<0.05).结论:大剂量呋塞米合并高渗盐水能显著提高顽固性心力衰竭的治疗成功率,缜密的护理措施是提高治愈率的有力保障.     

颞叶切除治疗癫痫8例的临床观察及护理

我国癫痫的患病率在7%,其中颞叶癫痫是最常见的癫痫类型.估计约20%～25%的癫痫患者属于顽固性癫痫,不能用药物控制发作,其中至少有50%的患者适宜手术治疗[1].随着视频脑电图和神经影像学的发展,对癫痫治病灶的定位更加准确,越来越多的药物难以控制的难治性的癫痫患者,通过手术得到了有效的治疗.颞叶癫痫的外科手术治疗效果好,安全有效.我院对8例颞叶癫痫患者实施手术治疗,疗效满意,现将我们的临床观察及护理体会介绍如下.     

顽固性癫痫大脑半球切除术10例围术期护理

目的:探讨顽固性癫痫行大脑半球切除术患者的围术期护理方法。方法:对10例顽固性癫痫行大脑半球切除术患者给予精心术前、术后护理。结果:本组中有1例行解剖性大脑半球切除,9例行改良性大脑半球切除。经随访,9例无癫痫发作1,例偶有发作,无一例发生肢体瘫痪。结论:加强顽固性癫痫行大脑半球切除术患者的围术期护理,可减少并发症发生,促进患者康复。     

介入栓塞治疗鼻出血的围手术期护理

目的:探讨顽固性鼻出血患者行介入栓塞治疗围手术期护理措施。方法:对12例顽固性鼻出血患者进行介入栓塞治疗,术前、术后严密观察病情,加强护理。结果:所有患者一次栓塞成功,达到止血目的,术中、术后无严重并发症发生。结论:介入栓塞对顽固性鼻出血疗效肯定,加强围手术期护理,密切观察病情变化,有利于防止并发症的发生,促进患者早期康复。     

磷酸肌酸钠治疗顽固性心力衰竭24例的护理

目的探讨磷酸肌酸钠治疗顽固性心力衰竭护理措施及效果。方法对应用磷酸肌酸钠治疗24例顽固性心力衰竭的患者护理的临床资料进行回顾性分析,观察用药护理、心理护理、饮食护理等有效护理措施对提高疗效的作用。结果 24例中显效17例,有效5例,无效2例,总有效率91.67%。结论磷酸肌酸钠治疗顽固性心力衰竭,配合有效的护理措施,疗效确切,可明显降低病死率。     

乳腺癌术后29例顽固性皮下积液个体化手术治疗临床护理

目的:探讨乳腺癌术后顽固性皮下积液个体化手术治疗的护理方法。方法:选择29例乳腺癌术后3～10个月的顽固性皮下积液患者,采用个体化手术治疗方案,加强术前的心理疏导,练习床上排便等特殊体位;术后严格制动,保证有效引流等护理措施。结果:29例乳腺癌术后顽固性皮下积液患者全部治愈,随访3个月,局部未再出现皮下积液。结论:加强心理疏导、严格制动、持续负压有效引流是乳腺癌术后顽固性皮下积液个体化手术治疗成功的护理关键。     

老年胃癌术后病人顽固性呃逆的临床分析及护理

[目的 ]探讨老年胃癌术后病人顽固性呃逆的常见原因。[方法 ]对 2 1例胃癌术后发生顽固性呃逆的老年病人进行回顾性分析。 [结果 ]胃癌术后发生顽固性呃逆的原因有低钠血症、胃胀气、酸中毒等。 [结论 ]呃逆的治疗应根据不同原因分别处理 ,才能取得满意的疗效。     

护理干预对小儿难治性癫痫坚持生酮饮食治疗的远期影响

目的:探讨护理干预对小儿难治性癫痫坚持生酮饮食治疗的影响.方法:将40例难治性癫痫患儿分为干预组20例和对照组20例,干预组给予住院期间和出院后的护理干预,包括饮食配制及管理、不良反应的观察及家庭护理指导、疾病的管理、心理干预等方面;对照组实施普通的护理干预.两组患儿均随访1年.结果:6个月、12个月时干预组坚持生酮饮食治疗的人数明显高于对照组(P﹤0.05,P﹤0.01).结论:运用护理干预方法可以大大提高患儿及家长的依从性和耐受性.     

Neurosurgical treatment of intractable epilepsy

Many patients with epilepsy are refractory to anticonvulsant therapy. For some, surgery is a means to control their seizures. Temporal lobectomy, the most common neurosurgical approach to intractable epilepsy, has resulted in improvement or cure in as many as 90% of treated individuals. To determine patients suitable for surgery, presurgical selection and evaluation criteria have been devised. With epilepsy surgery becoming more widely utilized and more centers appearing in the United States, there is a growing need for neuroscience nurses to know about recent developments. This overview of surgery for epilepsy includes the presurgical evaluation process through the postoperative phase presented from a nursing perspective.     

全程健康教育对难治性癫痫患儿生酮饮食治疗依从性的影响

目的 探讨全程健康教育对生酮饮食治疗患儿及家长疾病认知及治疗依从性的影响.方法 将69例使用生酮饮食治疗的难治性癫痫患儿按入院顺序随机分为对照组(34例)和实验组(35例).对照组采用常规护理,实验组在对照组的基础上对患儿及家长实施全程健康教育干预.采用自行设计调查表对2组患儿及家长进行干预前后的调查,采用x2检验比较2组患儿家长疾病认知知晓率、生酮饮食治疗依从性及治疗效果.结果 实验组患儿家长疾病认知知晓率、治疗依从性及治疗效果均明显高于对照组(P＜0.01).结论 全程健康教育可提高生酮饮食治疗患儿家长的疾病认知程度,可有效改善治疗依从性,提高治疗效果,从而提高难治性癫痫患儿的生活质量.     

Withholding aggressive seizure treatment from a child with severe intractable epilepsy: a case study.

A child with severe intractable epilepsy, profound neurological impairment, and frequent and lengthy admissions to the hospital for repeated and prolonged status epilepticus has an uncertain quality of life. The benefit and ethics of repetitive, aggressive seizure treatment are in question. This case study describes a healthcare team's experience when it was decided to withhold aggressive seizure treatment from a child with severe intractable epilepsy and transition to a palliative care approach. The situation leading up to this decision and the ethical dilemmas, nursing issues and interventions, and lessons learned are reviewed.     

Surgical management of intractable seizure disorders.

The surgical treatment of intractable seizures is still regarded by some as an experimental procedure with questionable rationale. However, in centers where care is taken in the selection process and facilities are available for adequate diagnosis, the procedure has been successful in complete alleviation of seizures in some cases. The decision about surgical interventions for epilepsy is never an easy one. Potential surgical candidates are evaluated by a team of specialists and undergo numerous diagnostic tests and examinations before a decision for surgery is made. It is essential for the neuroscience nurse to have knowledge of the underlying etiology of seizures, diagnostic testing and surgical procedures in order to effectively care for the seizure patient pre- and postoperatively. With this knowledge, nursing management becomes a vital part in the total treatment of the seizure patient.     

层级管理在外科护理中的应用

目的:探讨层级管理在外科护理中的应用效果.方法:选择本院外科病区全体护士16名,根据护士的综合能力分层级,对其实施分层级管理方法,比较实施护士分层级管理前(2008年12月~2009年12月)、后(2010年1月~2011年1月)外科病区护理质量和患者对护理服务满意度.结果:实施层级管理后,各项护理服务质量指标与患者对护理服务满意度均高于实施前(P＜0.05).结论:层级管理能提高护理质量,提高患者对护理服务的满意度,是一种切实可行的人性化护理管理方式.     

顽固性鼻出血血管造影栓塞术20例护理体会

目的:探讨数字减影血管造影(DSA)选择性血管栓塞治疗顽固性鼻出血的护理方法。方法:对20例顽固性鼻出血行DSA栓塞治疗患者加强病情观察和护理。结果:本组均一次彻底止血,随访3～6个月未再出血。6例出现同侧头面部疼痛,1例张口受限,经对症处理,均于术后1～2周内消失。结论:DSA栓塞治疗能有效阻断并永久性栓塞出血部位供血分支,严密观察及护理是减少并发症,提高治疗效果的重要保证。     

护理专案在癫痫患者立体定向脑电图定位手术中的应用

目的 探讨护理专案在癫痫患者立体定向脑电图定位手术中的效果。方法 分析立体定向脑电图定位手术并发症的性质及发生原因,给予护理专案管理措施。将北京市功能神经外科研究所2015年1月—2017年1月开展护理专案前接受立体定向脑电图定位手术的100例癫痫患者为对照组,将2017年2月—2019年1月开展护理专案后接受立体定向脑电图定位手术的158例癫痫患者为试验组,比较两组手术及护理并发症发生率的差异。结果 两组手术相关并发症的发生率差异无统计学意义（P>0.05）;试验组护理相关并发症的发生率低于对照组（P<0.05）。结论 护理专案的应用可显著减少癫痫患者立体定向脑电图定位手术护理相关并发症的发生。     

Postcraniotomy headache

BACKGROUND: Persistent headache following craniotomy has been reported in the past, but the clinical features of this condition have not been well described. OBJECTIVE: This study was undertaken to evaluate the incidence and clinical features of postcraniotomy headache. METHODS: The medical records of 107 patients who had undergone surgery for brain tumor or intractable epilepsy were reviewed. The clinical features of preoperative and postoperative headache and any headache therapy initiated were obtained from the medical records. The surgical site and the underlying pathology were documented. The subsequent course of the headache also was recorded. RESULTS: We evaluated 102 patients who underwent surgery: 76 for an underlying brain tumor, 21 for intractable epilepsy, and 5 for intracranial hemorrhage. Five patients were disqualified because of inadequate documentation. Fifty-eight patients did not complain of headache preoperatively. Eleven patients who did not have preoperative headache experienced headache postoperatively. Eight had undergone surgery for intractable epilepsy and 3 for brain tumor. Eighty-two percent of these patients experienced gradual resolution of their headaches over time, and most did not require major medical intervention for controlling their headache. No cases of debilitating headaches were identified. The majority of the headaches were located over the surgical site. CONCLUSIONS: The pathogenesis of postoperative headache remains unclear. The clinical characteristics of the headache following craniotomy suggest a combination of tension-type and "site-of-injury headache" overlying the surgical site. These headaches are similar to the headaches described following head trauma.