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目的探讨并检验延续性护理管理工作在急性蛛网膜下腔出血急诊实施介入治疗中的实用价值。方法选取2011年2月至2015年2月该院采用绿色通道救治新模式治疗急性蛛网膜下腔出血患者418例,对其进行急诊影像学诊断、急救处置和手术治疗等一体化专科急性救治的应用及实行相应治疗前、治疗中、治疗后延续性护理。结果术后并发症发生率15.9%,12例患者治疗无效死亡;16例患者出现脑血管痉挛严重脑水肿,行去骨骨瓣减压术,13例栓塞后脑出血,5例下肢静脉血栓形成,经积极治疗后给予抗炎、抗血管痉挛、控制血压、脱水治疗等对症处理好转;其余患者均康复出院。出院时脑卒中后恢复评分,1分者216例,2分者127例,3分者45例,4分者18例,6分者12例。结论积极有效、合理化、专科性、针对性的延续性护理管理在急性蛛网膜下腔出血的急性介入治疗中,能够缩短急性蛛网膜下腔出血患者的诊断及治疗时间,降低急性蛛网膜下腔出血患者再出血的风险,降低死亡率、致残率,减少并发症,提高患者的生存质量。
Objective To explore and test the practical value of continuous nursing management in the interventional treatment of acute subarachnoid hemorrhage. Methods A total of 418 patients with acute subarachnoid hemorrhage treated by the green channel in the hospital from February 2011 to February 2015 were selected for emergency treatment of acute SARS, including emergency diagnosis, emergency treatment and surgical treatment Application and implementation of the corresponding treatment before, during, after treatment, continuity of care. Results The incidence of postoperative complications was 15.9%, and 12 patients died of treatment ineffectiveness. Sixteen patients developed severe cerebral edema due to cerebral vasospasm, debridement and bone flap decompression, 13 cases of post-embolization cerebral hemorrhage, 5 cases of lower extremity venous thrombosis, After active treatment given anti-inflammatory, anti-vascular spasm, blood pressure control, dehydration and other symptomatic treatment improved; the rest of the patients were discharged. Post-stroke recovery score at discharge was 216 in 1, 127 in 2, 45 in 3, 18 in 4, and 12 in 6. Conclusion Acute, effective, rational, specialist and targeted continuous nursing management can shorten the diagnosis and treatment time of patients with acute subarachnoid hemorrhage and reduce acute subarachnoid space in acute interventional treatment of acute subarachnoid hemorrhage. The risk of rebleeding bleeding patients, reduce mortality, morbidity, reduce complications and improve the quality of life of patients.