摘要
目的:探讨机械取栓在治疗急性缺血性卒中(AIS)患者中的疗效和护理方法。方法:回顾性分析2019年4月~2020年3月黄山市人民医院神经内科收治的AIS给予机械取栓治疗的32例患者临床资料,术中采用脑梗死溶栓分级(TICI)评估血管再通情况,其中TICI 2b、3级视为血管成功再通。对比术前及出院时美国国立卫生研究院卒中量表评分(NIHSS)、日常生活自理能力(ADL)。并在术中术后严密观察并发症发生情况,围手术期给予针对性护理措施。术后90 d电话随访,对存活患者进行改良Rankin量表(mRS)评分。结果:(1)32例患者中84.4%(27/32)术中实现成功再通(TICI 2b、3级),15.6%(5/32)未能有效再通。术后即刻或24 h后头颅CT复查显示,并发大面积脑梗死1例,颅内出血1例,造影剂外渗6例。(2)出院时患者NIHSS评分较术前低,而ADL评分较术前上升,差异均有统计学意义(P<0.05)。术后90 d电话随访,存活的26例患者61.5%(16/26)达到良好的临床预后(mRS 0~2分)。结论:机械取栓治疗配合围手术期精细化的护理,可以改善AIS患者的预后,提高生活质量。
Objective:To observe the outcomes of nursing patients with acute ischemic stroke(AIS)undergone mechanical thrombectomy.Methods:Retrospective analysis was performed in 32 AIS patients treated by mechanical thrombectomy in the Department of Neurology of Huangshan People′s Hospital druing April 2019 and March 2020.Thrombolysis in Cerebral Infarction(TICI)grading system was used in operation to assess vascular recanalization,for which TICI grade 2 b or 3 was considered successful reperfusion.Incidence of intraoperative complications was observed,and tailored perioperative nursing measures were given to all patients.The nursing effects were evaluated by comparing the scores on National Institutes of Health Stroke Scale(NIHSS)and ability of daily living(ADL)before surgery and at discharge as well as scoring on Modified Rankin Scale(mRS)in survivors via telephone follow-up in 90 days after operation.Results:(1)Of the 32 patients,successful reperfusion was found in 84.4%(27/32),and failure was seen in 15.6%(5/32).Cerebral CT performed immediately or 24 h after surgery showed that concurrent massive cerebral infarction occurred in one patient,intracranial hemorrhage in another one,and contrast extravasation in 6;(2)Lower NIHSS scoring,yet higher ADL was seen at discharge compared to pre-operation.The difference was significant(P<0.05).Ninety days of telephone follow-up after surgery showed that 61.5%(16/26)of the 26 survivors were in better clinical prognosis(mRS 0-2).Conclusion:Quality perioperative nursing can improve the prognosis and quality of living in AIS patients undergone mechanical thrombectomy.
作者
胡玉萍
倪初源
HU Yuping;NI Chuyuan(Department of Neurology,People′s Hospital of Huangshan City,Huangshan 245000,China)
出处
《皖南医学院学报》
CAS
2021年第3期295-297,共3页
Journal of Wannan Medical College
基金
黄山市科技计划项目(2018KN-13)。
关键词
急性缺血性脑卒中
取栓
围手术期
护理观察
acute ischemic stroke
thrombectomy
perioperative period
nursing observation
