作　　者： (侯春梅）; (王会文）; (张雪梅）; (房辉）; (吕玉梅）; (韩如泉）;

机构地区： 首都医科大学附属北京天坛医院麻醉科,北京100050

出　　处： 《中华现代护理杂志》 2017年第17期2289-2291,共3页

摘　　要： 目的 回顾性调查帕金森病患者施行脑深部电刺激手术后麻醉恢复期常见并发症的发生情况,为临床及时给予有效护理干预措施提供依据.方法 选取2009年3月-2016年6月北京天坛医院神经外科帕金森病施行脑深部电刺激手术的患者869例,分析其麻醉恢复期情况,对呼吸系统、循环系统、疼痛、寒战、术后恶心/呕吐、躁动和苏醒延迟等并发症的护理进行总结.结果 869例脑深部电刺激手术的帕金森病患者麻醉恢复期并发症总的发生率为36.7%,其中高血压133例占15.3%,心律失常99例占11.4%,苏醒期躁动76例占8.7%,呼吸道梗阻24例占2.8%,术后恶心/呕吐18例占2.1%,低氧血症17例占2.0%,疼痛10例占1.2%,苏醒延迟10例占1.2%,寒战3例占0.3%,低血压1例占0.1%.患者转出恢复室时改良Aldrete评分≥9分849例,占97.7%,≤8分20例占2.3%.结论 帕金森病行脑深部电刺激手术患者麻醉恢复期并发症有特殊性,要保持循环稳定、防止呼吸系统并发症和误吸的发生,针对性的预防护理可保障患者的安全,提高护理质量. Objective To retrospectively investigate the incidence of complications for patients with Parkinson＆#39;s disease underwent deep brain stimulation in the anesthesia recovery period so as to provide timely and effective nursing interventions in clinical practice.Methods A total of 869 patients with Parkinson＇s disease underwent deep brain stimulation enrolled into neurosurgery from March 2009 to June 2016 in Beijing Tian Tan Hospital were recruited and the situation in the anesthesia recovery period were analyzed. Nursing of complications including circulatory and respiratory systems, pain, shiver, postoperative nausea and vomiting （PONV）, emergence delirium and delayed recovery were recorded.Results Totally 869 patients were enrolled in this study, 36.7% of which had complications as follows： hypertension （15.3%,n=133）, arrhythmia （11.4%,n=99）, emergence delirium （8.7%,n=76）, respiratory obstruction （2.8%,n=24）, PONV （2.1%, n=18）, hypoxemia （2.0%,n=17）, pain （1.2%,n=10）, delayed recovery （1.2%,n=10）, shiver （0.3%,n=3） and hypotension （0.1%,n=1）. It was found that 97.7% （n=849） of patients were discharged from the postanesthesia care unit with modified Aldrete score ≥9, while 2.3% （n=20） of patients had scores ≤8.Conclusions Patients with Parkinson＇s disease underwent deep brain stimulation have specific complications. It is important to keep a stable circulation and prevent respiratory complications and aspiration in the anesthesia recovery period. Individual nursing interventions can keep the safety of patients and increase the quality of nursing.

关 键 词： 帕金森病 麻醉恢复期 手术后并发症 脑深部电刺激术