护理学杂志2024，Vol.39Issue(23) ：24-29.DOI:10.3870/j.issn.1001-4152.2024.23.024

开颅术后患者经眼眶超声颅内压动态管理方案的构建与应用

Development and implementation of a care protocol based on dynamic management of intracranial pressure using transorbital sonography in patients after craniotomy

张效东 王杰敏 张庆海 刘永昊 王云鹏 李赞武
护理学杂志2024，Vol.39Issue(23) ：24-29.DOI:10.3870/j.issn.1001-4152.2024.23.024
✕
  • 维普
  • 万方数据

开颅术后患者经眼眶超声颅内压动态管理方案的构建与应用

Development and implementation of a care protocol based on dynamic management of intracranial pressure using transorbital sonography in patients after craniotomy

张效东 1王杰敏 1张庆海 1刘永昊 1王云鹏 1李赞武1
扫码查看

作者信息

  • 1. 潍坊市人民医院重症医学科(山东 潍坊,261000)
  • 折叠

摘要

目的 探讨经眼眶超声技术的颅内压动态管理方案在开颅术后患者中的实施应用效果.方法 将120例开颅术后患者采用抽签法分为对照组和干预组各60例.对照组采用开颅术后常规护理措施;干预组通过文献研究及德尔菲专家函询,构建经眼眶超声技术的颅内压动态管理方案并应用.比较两组患者转出ICU时的NIHSS评分和GCS评分,术后脑水肿、急性肾损伤、电解质紊乱(低钠、低钾、低钙)发生率,术后ICU住院时间、总住院时间.结果 干预组患者转出ICU时的NIHSS评分显著低于对照组,GCS评分显著高于对照组(均P＜0.05);干预组术后电解质紊乱发生率、术后ICU住院时间、总住院时间显著低于/短于对照组(均P＜0.05).结论 经眼眶超声技术的颅内压动态管理方案具有较好的科学性及可行性,可有效改善开颅术后患者神经功能,降低并发症的发生,缩短住院时间.

Abstract

Objective To explore the effect of a care protocol based on dynamic management of intracranial pressure(ICP)using transorbital sonography(TOS)in post-craniotomy patients.Methods A total of 120 post-craniotomy patients were randomly as-signed to one of two groups,with 60 in each.The control group received conventional postoperative nursing care,while the inter-vention group received care guided by dynamic measurements of ICP using TOS.The care protocol was developed through litera-ture review and expert consultation.The National Institutes of Health Stroke Scale(NIHSS)scores and the Glasgow Coma Scale(GCS)scores at transfer out of the ICU,the incidence of postoperative cerebral edema,acute kidney injury,and electrolyte dis-turbances(hyponatremia,hypokalemia,hypocalcemia),as well as length of ICU stay and hospital stay were compared between the two groups.Results The NIHSS score at transfer out of the ICU was significantly lower,whereas the GCS score was signifi-cantly higher in the intervention group compared with the control group(both P＜0.05).The incidence of electrolyte disturbances,length of ICU stay,and hospital stay in the intervention group were significantly lower/shorter than those in the control group(all P＜0.05).Conclusion The care protocol based on dynamic management of ICP using TOS is scientific and feasible,and can effec-tively improve neurological function of post-craniotomy patients,reduce the incidence of complications,and shorten the length of hospitalization.

关键词

开颅手术/颅内压/经眼眶超声技术/超声监测/重症超声/德尔菲法/脑水肿/神经外科护理

Key words

craniotomy/intracranial pressure/transorbital sonography/ultrasound monitoring/critical care ultrasonogra-phy/Delphi technique/cerebral edema/neurosurgical care

引用本文复制引用

出版年

2024
护理学杂志
华中科技大学同济医学院

护理学杂志

CSTPCDCSCD北大核心
影响因子：2.062
ISSN：1001-4152
段落导航相关论文