心源性脑栓塞护理分析_West China Medical Journal

Authors：

 王雪艳 , 杨文兵 ,  杨蓉

四川大学华西医院神经内科（成都，610041）;

Corresponding author：

杨蓉, Email: hxyangrong2004@126.com

Keywords：

脑栓塞; 心源性; 护理

DOI：

10.7507/1002-0179.20140437

Video：

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目的探讨心源性脑栓塞的护理措施及要点。方法对2013年6月－2014年3月急诊入院的74例心源性脑栓塞患者，采取严密监测、对症护理、侧重重点、分步处置的护理对策。对神经系统早期以处置意识障碍、预防神经系统症状加重为主；中期以避免并发呼吸系统、泌尿系统、皮肤系统并发症的护理及心理护理为主；后期以饮食和功能康复训练为主；其心脏护理贯穿于整个护理过程中。结果 74例患者在救治基础上均得到精心周全的护理，康复或好转后直接出院57例（其中出院择期等待心脏手术25例），安全转科治疗心脏原发病7例，死亡10例，平均住院13.7 d。结论心源性脑栓塞护理涉及心脑两方面，问题交织复杂。护理目标和护理措施要掌握规律性，即对心血管的护理要贯穿始终，以心力衰竭纠正与否来确定护理重点；而对神经性的护理则应注意阶段性和掌握侧重点。

Citation： 王雪艳, 杨文兵, 杨蓉. 心源性脑栓塞护理分析. West China Medical Journal, 2014, 29(8): 1421-1423. doi: 10.7507/1002-0179.20140437 Copy

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1. Yang G, Wang Y, Zeng Y, et al. Rapid health transition in China, 1990-2010:findings from the Global Burden of Disease Study 2010[J]. Lancet, 2013, 381(9882):1987-2015.
2. Liu L, Wang D, Wong KS, et al. Stroke and stroke care in China:huge burden, significant workload, and a national priority[J]. Stroke, 2011, 42(12):3651-3654.
3. Wang Y, Liao X, Zhao X, et al. Using recombinant tissue plasminogen activator to treat acute ischemic stroke in China:analysis of the results from the Chinese National Stroke Registry (CNSR)[J]. Stroke, 2011, 42(6):1658-1664.
4. Dietl M1, Pohle R, Weingärtner M, et al. Stroke etiology and long-term need of care in ischemic stroke patients[J]. Fortschr Neurol Psychiatr, 2009, 77(12):714-719.
5. Gao S, Wang YJ, Xu AD, et al. Chinese ischemic stroke subclassification[J]. Front Neurol, 2011, 15(2):1-6.
6. 重组组织型纤溶酶原激活剂治疗缺血性卒中共识专家组. 临床应用rt-PA静脉溶栓治疗缺血性卒中专家共识[J]. 中华内科杂志, 2006, 45(7):613-614.
7. 胡大一, 郭艺芳. 心房颤动抗凝治疗中国专家共识[J]. 心脑血管病防治, 2012, 12(3):173-177.
8. 他汀类药物防治缺血性卒中/短暂性脑缺血发作专家共识组. 他汀类药物防治缺血性卒中/短暂性脑缺血发作专家共识[J]. 中国卒中杂志, 2013, 8(7):565-575.
9. Cornett O, Ocava LC, Singh M, et al. Antithrombotic and thrombolytic therapy for ischemic stroke[J]. Cardiol Clin, 2008, 26(2):251-65.
10. 周泽纯, 田杏音. 心源性脑栓塞急性期的护理观察[J]. 广州医药, 2013, 44(5):71-72.
11. Fonarow GC, Zhao X, Smith EE, et al. Door-to-needle times for tissue plasminogen activator administration and clinical outcomes in acute ischemicstroke before and after a quality improvement initiative[J]. JAMA, 2014, 311(16):1632-40.
12. 罗颖, 徐程莹. 康复训练和出院后康复督导对脑梗塞康复的影响[J]. 中华全科医学, 2011, 9(10):1646-1647.

West China Medical Journal

心源性脑栓塞护理分析

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