34例重症脑出血患者临床观察及护理.docVIP

34例重症脑出血患者临床观察及护理[摘要] 目的 总结34例脑出血患者的临床护理要点。方法 回顾分析2010年1～12月份本院34例脑出血患者的临床资料，并总结护理经验。 结果 34例中有15例脑出血患者康复后神志清醒，左侧肢体乏力可持物行走，部分生活护理可自理；5例神志浅昏迷、失语、四肢肢体偏瘫；7例神志清，言语含糊，一侧肢体偏瘫；4例植物生存，3例死亡。结论 脑出血患者病情危重，病程长，加强对患者的观察和护理可以有效提高患者肢体、语言、认知功能等方面的能力，对于降低患者致残率和死亡率起着重要作用。 [关键词] 脑出血；失语；昏迷 [中图分类号] R473 [文献标识码] B [文章编号] 1673-9701（2011）31-106-02 The Clinical Observation and Neurology for 34 Patients with Severe Cerebral Hemorrhage WANG Huahao Third Department of Neurology，Yangjiang Municipal Peoples Hospital in Guangdong Province，Yangjiang 529500，China [Abstract] Objective To summarize the main nursing points for 34 patients with cerebral hemorrhage. Methods The clinical data of 34 patients with cerebral hemorrhage during Jan to Dec 2010 in our hospital were retrospectively analyzed and the nursing experience were summarized. Results With left limbs acratia but could walk by stick，14 patients were sober and self-care. 5 patients were hemiplegic，aphasia and in a light coma. With words indistinct and one side of limb hemiplegic，7 patients were sober. 4 patients were in a vetetative state and 3 patients were dead. Conclusion The severe cerebral hemorrhage runs a long course. Strict observation and nursing help can improve their activities at limbs，language，cognition as well. It can also play a important role to reduce the disability and mortality. [Key words] Cerebral hemorrhage；Aphasia；Coma 脑出血是指原发性非外伤脑室质内的出血[1]，占全部脑卒中的20%～30%，病死率高、致残率高。脑出血的发病常常无先兆，突然起病而急骤，并在数分钟内至数小时内达到高峰，患者典型症状表现为头痛、昏迷、呕吐、失语、意识障碍、偏瘫、抽搐、大小便失禁等。脑出血病具有起病急、变化快、抢救和诊治复杂等特点，康复的时间较长，护理工作者严密观察脑出血患者的病情变化，做好急性期和恢复期的护理，做到全面、细致、周到，有助于降低患者并发症的发生，使患者早日康复。本文总结了本院脑出血患者急性期、恢复期、预防并发症等护理经验体会，现报道如下。 1 资料与方法 1.1 一般资料 抽选本科室2010年1～12月脑出血患者34例，其中男19例，女15例，年龄35～78岁，15例因无明显诱因突然不省人事、跌倒在地，收入院，入院时浅昏迷状，呼之不应，伴呕吐非咖啡色样胃内物数次，量不多，查头颅CT脑出血收入我科，9例患者入院时嗜睡状，呼之睁眼，对答不切题，左侧肢体肌力0级，3例因病情危重，抢救无效死亡，7例有明显剧烈头痛，有高血压病史。 1.2 方法 对本组34例患者密切观察病情变化并进行密切记录，总结临床各种护理经验细心地去护理患者，询问患者既往有无高血压病史或脑动脉硬化史；起病前有无明显的诱发因素，如情绪激动、劳累或用力排便、精神紧张等，发病后密切关注有无