外伤性蛛网膜下腔出血持续腰池引流的护理干预

目的 探讨持续腰池引流治疗外伤性蛛网膜下腔出血的临床疗效及护理干预价值.方法 将68例外伤性蛛网膜下腔出血行持续腰池引流的患者随机分为对照组和观察组各34例,观察组患者进行术前、术中、术后神经外科专科护理干预,对照组用神经外科常规护理,比较两组疗效及并发症的发生情况.结果 两组均无死亡,恢复良好,生活能自理.并发症发生情况：对照组颅内感染10例,观察组3例（x2 =4.66,P＜0.05）;对照组引流管堵塞13例,观察组5例（x2 =4.84,P＜0.05）;对照组发生穿刺部位脑脊液漏8例,观察组2例（x2=4.21,P＜0.05）.结论 持续腰池引流可减轻血性脑脊液对脑及脑膜的刺激,促进脑脊液的循环和吸收,缓解脑血管痉挛,改善脑缺血情况,减轻脑水肿和脑梗死的发生,还可避免反复腰穿对患者带来的痛苦.有针对性的专科护理有利于减少并发症,提高疗效,利于患者康复.

Investigation of nursing intervention of continuous lumbar drainage in treatment of traumatic subarachnoid hemorrhage

Objective To investigate the clinical efficacy and nursing intervention in treatment of traumatic sub- arachnoid hemorrhage with continuous lumbar drainage. Methods 68 cases of traumatic subarachnoid hemorrhage treated with continuous lumbar drainage were randomly divided into the observation group and the control group. The observa- tion group of patients received a neurosurgery specialist care, while the control group received a regular care. Their com- plications were compared. Results The control group had 10 cases of intraeranial infection, 13 cases of drainage tube blockage, and 8 eases of leakage of cerebrospinal fluid from the puncture sites, while the observation group had only 3 ca- ses of intraeranial infection （x2=4.66, P〈0. 05）, 5 cases of drainage tube blockage （x2 -= 4. 84, P〈0. 05）, and 2 cases of leakage of cerebrospinal fluid from the puncture sites （x2= 4.21, P〈0. 05 ）. There were no deaths in both group, and they all recovered well without any problems on independent life. Conclusion Continuous lumbar drainage is good to re- lieve the BCSF stimulation of brain and meninges, it could promote the circulation and absorption of eerebrospinal fluid, and relieve cerebral vasospasm, it could also improve cerebral ischemia, reducing the occurrence of cerebral edema and cerebral infarction, it also avoid repeated lumbar puncture which increases patients＂ pain. Quality specialist care is condu- cive to reduce complications and improve efficacy, and it is good for rehabilitation.