刘原

[摘要] 目的 探讨预见性护理在颅内动脉瘤夹闭术围术期中的应用效果。 方法 选取2015年1月～2019年6月在我科行颅内动脉瘤夹闭术的患者58例作为研究对象，随机分为预见性护理组（29例，采用预见性护理措施）和常规护理组（29例，给予常规护理方案）。比较两组患者术后并发症、术后SCL-90评分及术后恢复情况。 结果 预见性护理组术后脑血管痉挛、电解质紊乱及并发症总发生率低于常规护理组（P<0.05）。预见性护理组SCL-90各项因子评分均低于常规护理组（P<0.05）。两组患者术后恢复情况比较差异无统计学差异（P>0.05）。 结论 颅内动脉瘤夹闭术围术期预见性护理可有效降低患者的术后并发症发生率，改善患者心理状态，有利于患者术后恢复。

[关键词] 颅内动脉瘤;夹闭术;预见性护理;并发症;心理状态

[中图分类号] R473.6          [文献标识码] B          [文章编号] 1673-9701（2020）22-0182-04

An evaluation of the application of predictive nursing in perioperative period of clipping of intracranial aneurysm

LIU Yuan

Department of Neurosurgery， Xinyi People's Hospital in Jiangsu Province， Xinyi   221400， China

[Abstract] Objective To evaluate the application effect of predictive nursing in perioperative period of clipping of intracranial aneurysm（ICA）. Methods 58 patients who underwent clipping of ICA in our department from January 2015 to June 2019 were selected as the subjects of research and randomLy divided into the predictive nursing group（29 patients receiving predictive nursing measures） and the routine nursing group（29 patients given routine nursing plan）. The postoperative complications， postoperative SCL-90 scores and postoperative recovery were compared between the patients of the two groups. Results The total incidence of postoperative cerebral vasospasm（CVS）， electrolyte disturbance and complications in the predictive nursing group was lower than that in the routine nursing group（P<0.05）. The scores of various SCL-90 factors of the predictive nursing group were lower than those of the routine nursing group（P<0.05）. There was no statistically significant difference in postoperative recovery between the patients of the two groups（P>0.05）. Conclusion Predictive nursing in perioperative period of clipping of ICA can effectively reduce the incidence of postoperative complications for the patients and ameliorate their psychological state， thus facilitating the patients postoperative recovery.

[Key words] Intracranial aneurysm（ICA）; Clipping; Predictive nursing; Complication; Psychological state

顱内动脉瘤是神经外科常见疾病之一，患者可因情绪激动、过度紧张、兴奋、悲伤、用力等多种情况发生动脉瘤破裂，进而发生蛛网膜下腔出血，具有较高的病死率[1-2]。目前临床治疗方式以手术为主，如血管介入栓塞、外科夹闭术等[3]。有研究显示，围术期护理是加强手术治疗效果的关键，做好患者的围术期护理已成为临床护理研究的重点[4]。本研究考察了预见性护理在颅内动脉瘤夹闭术围术期中的护理优势，现报道如下。

1 资料与方法

1.1 一般资料

选取2015年1月～2019年6月在新沂市人民医院神经外科行颅内动脉瘤夹闭术的患者作为研究对象。纳入标准：（1）所有患者均经脑血管高能数字减影血管造影技术（Digital subtraction angiography，DSA）确诊[5-6];（2）患者及家属知情同意并签署同意书。排除标准：（1）患者有麻醉药过敏史;（2）有精神疾病史或有认知障碍的患者;（3）检测指标不完整。……