[1]纪凡,王娜,施晓庆,等.高血压性脑出血小骨窗开颅术围手术期护理[J].中国临床神经外科杂志,2024,29(08):508-512.[doi:10.13798/j.issn.1009-153X.2024.08.015]
　JI Fan,WANG Na,SHI Xiao-qing,et al.Perioperative nursing care for hypertensive intracerebral hemorrhage treated with small bone window craniotomy[J].,2024,29(08):508-512.[doi:10.13798/j.issn.1009-153X.2024.08.015]
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高血压性脑出血小骨窗开颅术围手术期护理()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
29
期数:
2024年08期
页码:
508-512
栏目:
综述
出版日期:
2024-08-30

文章信息/Info

Title:
Perioperative nursing care for hypertensive intracerebral hemorrhage treated with small bone window craniotomy
文章编号:
1009-153X（2024）08-0608-05
作者:
纪凡; 王娜; 施晓庆; 张燕; 舒伟
100053北京，首都医科大学宣武医院北京功能神经外科研究所（纪凡、施晓庆、张燕、舒伟），神经外科（王娜）
Author(s):
JI Fan1;  WANG Na2;  SHI Xiao-qing1;  ZHANG Yan1;  SHU Wei1
1. Beijing Institute of Functional Neurosurgery, Xuanwu Hospital of Capital Medical University, Beijing 100053, China; 2. Deparment of Neurosurgery, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
关键词:
高血压性脑出血; 小骨窗开颅术; 围手术期; 护理
Keywords:
Hypertensive cerebral hemorrhage;  Small bone window craniotomy;  Perioperative period;  Nursing
分类号:
R 743.34; R 473.6
DOI:
10.13798/j.issn.1009-153X.2024.08.015
文献标志码:
A
摘要:
高血压性脑出血（HCH）是神经外科常见的急危重症。小骨窗开颅血肿清除术是临床上治疗HCH的常见手术方案，具有快速清除血肿、降低颅内压、减少血肿对周围脑组织损伤等优点。由于小骨窗开颅血肿清除术属于侵入式操作，会对脑组织造成不同程度的损伤，导致术后出现并发症，影响病人的预后。科学、全面的围术期护理能有效降低并发症的发生率，改善病人的预后。目前，小骨窗开颅血肿清除术围手术期护理的研究较多，但缺乏统一、规范的指导。本文就小骨窗开颅血肿清除术的术前准备、术后康复与饮食等护理、术后并发症预防等研究进展进行总结，为小骨窗开颅血肿清除术围手术期的护理提供更为切实可行的措施和手段。
Abstract:
Hypertensive cerebral hemorrhage (HCH) is a common critical and emergent disorder in neurosurgery. Small bone window craniotomy for hematoma evacuation is a common surgical option for the treatment of HCH in clinical practice, which has the advantages of rapid hematoma removal, reduction of intracranial pressure, and minimization of damage to the surrounding brain tissue caused by the hematoma. Since the small bone window craniotomy for hematoma evacuation is an invasive procedure, it causes varying degrees of damage to the brain tissue, resulting in postoperative complications and influencing the prognosis of patients. Scientific and comprehensive perioperative care can effectively lower the incidence of complications and improve the prognosis of patients. At present, there are numerous studies on the perioperative care of small bone window craniotomy for hematoma evacuation, but there is a lack of unified and standardized guidance. This paper summarizes the research progress in preoperative preparation, postoperative rehabilitation and dietary care, and prevention of postoperative complications of small bone window craniotomy for hematoma evacuation, providing more practical and feasible measures and approaches for perioperative care of this procedure.

参考文献/References:

[1]CHINESE SOCIETY OF NEUROLOGY, CHINESE STROKE SOCIETY. Chinese guidelines for diagnosis and treatment of acute intra-cerebral hemorrhage 2019[J]. Chin J Neurol, 2019, 52(12): 994-1005. 中华医学会神经病学分会，中华医学会神经病学分会脑血管病学组.中国脑出血诊治指南（2019）[J]. 中华神经科杂志，2019, 52（12）：994-1005.
[2]LAU D, EL-SAYED AM, ZIEWACZ JE, et al. Postoperative out-comes following closed head injury and craniotomy for evacuation of hematoma in patients older than 80 years[J]. J Neurosurg, 2021, 116(1): 234-245.
[3]GALGANO M, TOSHKEZI G, QIU X, et al. Traumatic brain injury: current treatment strategies and future endeavors[J]. Cell Transplant, 2017, 26(7): 1118-1130.
[4]LIN ZB, ZHONG YG, FENG LY. Treatment of chronic subdural hematoma by borehole drainage and small bone window craniotomy for hematoma removal[J]. China Health Standard Manag, 2022, 13 (1): 58-61. 林宗保，钟元冠，冯良应. 钻孔引流术与小骨窗开颅血肿清除术治疗慢性硬膜下血肿[J]. 中国卫生标准管理，2022，13（1）：58-61.
[5]ZHAO J, ZHOU C. The protective and hemodynamic effects of dex-medetomidine on hypertensive cerebral hemorrhage patients in the perioperative period[J]. Exp Ther Med, 2016, 12(5): 2903-2908.
[6]WANG W, LV W, YANG J. Analysis of efficacy and safety of modified transfrontal puncture drainage in hypertensive basal ganglia hemorrhage patients[J]. Front Surg, 2022, 9: 837008-837015.
[7]MAO Y, SHEN Z, ZHU H, et al. Observation on therapeutic effect of stereotactic soft channel puncture and drainage on hypertensive cerebral hemorrhage[J]. Ann Palliat Med, 2020, 9(2): 339-345.
[8]LU Y. Summarizing the experience of holistic nursing in hypertensive cerebral hemorrhage with small bone window craniotomy[J]. Anhui Med J, 2013, 34(4): 499-502. 陆　燕. 整体护理运用于高血压脑出血小骨窗开颅术的体会[J].安徽医学，2013，349（4）：499-502.
[9]MEN D, HUANG Z, YIN Y, et al. Advantages of small bone-window craniotomy under microscope combined postoperative intracranial pressure monitoring in the treatment of hypertensive intracerebral hemorrhage[J]. J Craniofac Surg, 2021, 32(1): e77-e80.
[10]NGUYEN HS, DOAN N, WOLFLA C, et al. Fenestration of bone flap during decompressive craniotomy for subdural hematoma[J]. Surg Neurol Int, 2016, 7: 16-19.
[11]CHENG TW, FARBER A, LEVIN SR, et al. Perioperative outcomes for centers routinely admitting postoperative endovascular aortic aneurysm repair to the ICU[J]. J Am Coll Surg, 2021, 232(4)：6234.
[12]ZHAO LL. Effect of holistic nursing on hypertensive intracerebral hemorrhage after small bone window craniotomy for hematoma removal[J]. Guide China Med, 2021, 19(7): 230-231. 赵玲玲. 整体护理对高血压脑出血行小骨窗开颅血肿清除术后的影响[J]. 中国医药指南，2021，19（7）：230-231.
[13]LIU WL, LUO LZ. Effect of perioperative nursing intervention on craniotomy hematoma clearance of small bone window in hypertensive intracerebral hemorrhage[J]. Med Inform, 2018, 31(2): 166-167. 刘伟兰，罗丽珍. 围手术护理干预在高血压脑出血小骨窗开颅血肿清除术中的效果观察[J]. 医学信息，2018，31（2）：166-167.
[14]SUN L, LIU K, LI X, et al. Benefit finding experiences of cervical cancer survivors in rural Yunnan province, China: a qualitative study[J]. Nurs Open, 2022, 9(6): 2637-2645.
[15]NAFTALOVICH R, ZHONGYING A, FOX A. Family inclusion in end-of-life perioperative care[J]. Ann Thorac Surg, 2021, 22(15): 1052-1057.
[16]STREET M, DEMPSTER J, BERRY D, et al. Enhancing active patient participation in nursing handover: a mixed methods study [J]. J Clin Nurs, 2022, 31(7-8): 1016-1029.
[17]KINNUNEN KM, VIKHANOVA A, LIVINGSTON G. The management of sleep disorders in dementia: an update[J]. Curr Opin Psychiatry, 2017, 30(6): 495-497． [18]ZHAO PP, ZHANG J. Exploration on the methods of comfortable nursing during removal of hematoma craniotomy and decompressive craniotomy[J]. China Contin Med Edu, 2021, 13(3): 185-189. 赵莉萍，张　晋. 探究开颅血肿清除术和去骨瓣减压术中舒适护理的方法[J]. 中国继续医学教育，2021，13（3）：185-189.
[19]CONNELLY L, CRAMER E, DEMOTT Q, et al. The optimal time and method for surgical prewarming: a comprehensive review of the literature[J]. J Perianesth Nurs, 2017, 32(3): 199-209.
[20]CHEN LH, ZENG SX, HENG FZ. Investigootion the common problems of intraoperative cooperation in hematoma evacuation by craniotomy and nursing counter measures[J]. Nurs Prac Res, 2016, 13 (17): 121-123. 陈丽欢，曾素霞，何凤贞. 开颅血肿清除术术中配合常见问题调查分析及护理对策[J]. 理实践与研究，2016，13（17）：121-123.
[21]BESSON AJ, KEI C, DJORDJEVIC A, et al. Does implementation of and adherence to enhanced recovery after surgery improve perioperative nutritional management in colorectal cancer surgery[J]. ANZ J Surg, 2022, 92(6): 1382-1387.
[22]BONEY O, MOONESINGHE S, MYLES P, et al. Core Outcome Measures for Perioperative and Anaesthetic Care (COMPAC): a modified Delphi process to develop a core outcome set for trials in perioperative care and anaesthesia[J]. Br J Anaesth, 2021, 11(1): 52-57.
[23]LIU JZ. Comparison of small bone window craniotomy evacuation of hematoma and traditional craniotomy evacuation of hematoma in the treatment of cerebral hemorrhage[J]. Int Med Health Guid News, 2017, 23(8): 1181-1183. 刘金志. 小骨窗开颅血肿清除术和传统开颅血肿清除术治疗脑出血的疗效对比分析[J]. 国际医药卫生导报，2017，23（8）：1181-1183.
[24]LI YM, PENG YY, SHEN XF. Effects of cross pressure bandaging without sandbags on the risk of haemorrhagein patients of full cerebral digital subtraction angiography via femoral artery puncture[J]. Nurs J Chin PLA, 2016, 33(3): 62-64. 李渊妹，彭筠昀，沈小芳. 经股动脉穿刺行全脑血管造影术后患者穿刺点去除沙袋“十字”加压包扎止血的效果[J]. 解放军护理杂志，2016，33（3）：62-64.
[25]ADACHI H, WAKIMOTO S, ANDO K, et al. Optimal chest drainage method after anatomic lung resection: a prospective observational study[J]. Ann Thorac Surg, 2023, 115(4): 845-852.
[26]KATSUKI M, KAKIZAWA Y, NISHI A, et al. The dataset on the characteristics of the intracerebral hemorrhage patients treated by endoscopic hematoma removal or craniotomy[J]. Data Brief, 2020, 11(7): 952-959 [27]YOUSSEF ALI AMER A, WOUTERS F, VRANKEN J, et al. Vital signs prediction and early warning score calculation based on continuous monitoring of hospitalised patients using wearable technology [J]. Sensors, 2020, 20(22): 6593-6613.
[28]SU W, GAO C, WANG P, et al. Correlation of circulating T lympho-cytes and intracranial hypertension in intracerebral hemorrhage[J]. World Neurosurg, 2017, 107: 389-395.
[29]HONG NI, ROOM O. Effect of high quality nursing on perioperative craniotomy for hematoma removal combined with decompressive craniectomy[J]. Med Pharmac J, 2016, 11(7): 462-467.
[30]CHEN X. Clinical study of stroke rehabilitation nursing in neurology nursing[J]. Invest Clin, 2020, 61(2): 1014-1023.
[31]ZHU T, LIU H, HAN A, et al. Orem's self-care to treat acute coro-nary syndrome after PCI helps improve rehabilitation efficacy and quality of life[J]. Am J Transl Res, 2021, 13(4): 2752-2762.
[32]SONNEN VG. Segmental reflex therapy for neurogenic contractures: a clinical study[J]. Clin Rehabil, 1992, 6(4): 341-344.
[33]ZHANG H, GAO XF, HUANG CG. Effect of structured psychological nursing on psychological uncertainty and clinical prognosis in patients with aneurysm undergoing craniotomy[J]. J Guangxi Univ （Natural Science Edition）, 2019, 44(6): 1790-1795. 张　红，高秀芳，黄重光，等. 结构式心理护理对行开颅手术夹闭动脉瘤患者心理不确定感和临床预后的影响研究[J]. 广西大学学报（自然科学版），2019，44（6）：1790-1795.
[34]LENG Y, WU Y, WANG Z, et al. A qualitative study exploring barriers and facilitators to establishing nurse-led, multidisciplinary psychological care for trauma patients: experiences from doctors and nurses[J]. BMC Nurs, 2022, 21(1): 191.
[35]SONG Q, NEUROSURGERY DO, HOSPITAL S, et al. Analysis of influential factors of delayed intracranial hematoma after emergency intracranial hematoma in patients with craniocerebral injury[J]. Contemp Med, 2018, 3(13): 179-183.
[36]SCHWINGSHACKL L, ZOHRINGER J, BEYERBACH J, et al. Total dietary fat intake, fat quality, and health outcomes: a scoping review of systematic reviews of prospective studies[J]. Ann Nutr Metab, 2021, 77(1): 4-15.
[37]GUI C, GAO Y, HU D, et al. Neuroendoscopic minimally invasive surgery and small bone window craniotomy hematoma clearance in the treatment of hypertensive cerebral hemorrhage[J]. Pak J Med Sci, 2019, 35(2): 377-382.
[38]DU XP, CHEN CL, CHEN YX, et al. Bundle care to reduce incidence of catheter-associated urinary tract infection in elderly inpatients[J]. J Nurs, 2021, 28(18): 12-16. 杜雪萍，陈婵玲，陈燕珣，等. 降低老年住院患者留置尿管相关尿路感染发生率的集束化护理实践[J]. 护理学报，2021，28（18）：12-16.
[39]NIU XJ. Observation on the effect of atomized inhalation of budeso-nide combined with vibration expectoration on children with pediatric asthmatic pneumonia[J]. Reflexol Rehabil Med, 2022, 3(24): 114-116, 150. 牛星杰. 雾化吸入布地奈德联合振动排痰治疗喘息性肺炎患儿效果观察[J]. 反射疗法与康复医学，2022，3（24）：114-116，150.
[40]LONJARET L, GUYONNET M, BERARD E, et al. Postoperative complications after craniotomy for brain tumor surgery[J]. Anaesth Crit Care Pain Med, 2017, 36(4): 213-218.

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备注/Memo

备注/Memo:
（2023-07-03收稿，2023-12-28修回）
基金项目：北京市自然科学基金（Z210009）
更新日期/Last Update: 2024-08-30