CAJ | 학술논문

目的总结术中进行脑脊液引流的胸腹主动脉瘤手术患者围手术期护理经验.方法对15例术中进行脑脊液引流的胸腹主动脉瘤患者进行临床观察,分析有无脊髓损伤发生.结果所有患者的手术时间为(7.4±2.3)h,体外循环时间为(162.9±94.4)h,脑低灌注时间为(15.9±9.3)h,脊髓缺血时间为(21.5±12.4)h;1例患者因呼吸衰竭继发多脏器功能衰竭而死亡,其余患者均痊愈出院.脑脊液引流方面有2例患者出现脑脊液漏,经及时发现和加压上压迫后消失,未出现感染、脑疝等其他严重并发症.结论在适度引流前提下,通过加强严格、合理而完善的围手术期脑脊液引流的护理,可预防感染、出血和脑脊液漏等并发症的发生.胸腹主动脉瘤手术患者通过脑脊液引流进行脊髓保护是安全、可行和有效的.
목적 총결술중진행뇌척액인류적흉복주동맥류수술환자위수술기호리경험.방법 대15례술중진행뇌척액인류적흉복주동맥류환자진행림상관찰,분석유무척수손상발생.결과 소유환자적수술시간위(7.4±2.3)h,체외순배시간위(162.9±94.4)h,뇌저관주시간위(15.9±9.3)h,척수결혈시간위(21.5±12.4)h;1례환자인호흡쇠갈계발다장기공능쇠갈이사망,기여환자균전유출원.뇌척액인류방면유2례환자출현뇌척액루,경급시발현화가압상압박후소실,미출현감염、뇌산등기타엄중병발증.결론 재괄도인류전제하,통과가강엄격、합리이완선적위수술기뇌척액인류적호리,가예방감염、출혈화뇌척액루등병발증적발생.흉복주동맥류수술환자통과뇌척액인류진행척수보호시안전、가행화유효적.
Objective To report the experience of perioperative nursing care of 15 cases of thoracoabdominal aortic aneurysm patients who underwent cerebrospinal fluid drainage. Method Totally 15 cases of patients undergoing thoracoabdominal aortic aneurysm replacement and cerebrospinal fluid drainage were enrolled. The occurrence of spinal cord injury was detected by clinical examination,ultrasonic cardiogram and the scoring according to the National Institutes of Health Stroke Scale and International Standards for Neurological Classification of Spinal Cord Injury score at 3th days after operation and at discharge. Results The leakage of cerebrospinal fluid occurred in two patients and was healed by being detected in time and by compression bandaging. No other serious complications such as infection and hemorrhage occurred. Conclusion Complications such as infection,hemorrhage,leakage of cerebrospinal fluid can be prevented by nursing those patients strictly,appropriately and consummately on the basis of moderately dainage. It is safe,feasible and efficient to protect spinal cord by cerebrospinal fluid drainage for patients undergoing thoracoabdominal aortic aneurysm repair.