临床医学论文：代发高血压脑出血内科保守治疗的疗效及护理效果观察

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1、临床医学论文：代发高血压脑出血内科保守治疗的疗效及护理效果观察 摘要：目的 对应用内科保守治疗法对高血压脑出血的患者进行治疗所取得效果和护理的相关措施及体会进行进行总结性分析。方法 抽取90例患有高血压脑出血的临床确诊患者病例，将其分为A、B两组，平均每组45例，静脉注射依达拉奉进行治疗。在治疗过程中分别采用常规方式和针对性综合护理方法进行护理。结果 B组患者在治疗和护理后所取得效果明显优于A组患者;该组患者的治疗的安全性明显高于A组患者;该组患者治疗后出现再出血现象的人数明显少于A组患者。结论 应用内科保守治疗法对高血压脑出血的患者进行治疗，并在治疗后对其进行针对性的综合护理，可以

2、使该类患者治疗所取得效果明显提高。关键词：内科保守治疗法,高血压脑出血,护理,临床医学论文代发高血压脑出血(HICH)是目前临床上比较常见的一种急性脑血管疾病，主要具有发病急、病情严重、患者的致死致残率非常高等特点，在大量出血后，采用微创颅内血肿清除术是目前临床对该类患者进行紧急救治主要方法,对应用内科保守治疗法对高血压脑出血的患者进行治疗所取得效果和护理的相关措施及体会进行总结性分析，帮助临床对高血压脑出血患者的症状进行更加详细的了解，以便更加优质的为高血压脑出血患者提供治疗和护理服务，使患者治疗取得更加理想的效果，我们组织进行了本次研究。临床医学论文代发期刊海南医学杂志的前身为海南卫生，1

3、989年经国家新闻出版署批准，正式国内外公开发行，主管单位为海南省卫生厅，由海南省医学会主办。1 资料和方法1.1 一般资料采用临床研究过程中常用的随机分组方法，在过去一段时间(2007年9月至2011年9月)，抽取由于高血压脑出血来我院就诊的90例临床确诊患者病例。划分在A组的研究对象中有男性患者24例，女性患者21例;该组研究对象中年龄最大者75岁，年龄最小者23岁，平均年龄47.8岁;该组研究对象中年龄最大者78岁，年龄最小者44岁，平均年龄67.7岁。所抽取患者的所有自然资料，不具有明显的统计学差异，可以在研究过程中予以分析比较。在接受治疗前，所有患者都经过了相关的临床检查之后予以确诊

4、。1.2 方法将抽取的90例临床研究对象资料，进一步分为A、B两组，平均每组45例，采用静脉注射依达拉奉(静脉注射，每次30mg，每天两次，坚持治疗两个星期)的方法进行治疗。在治疗过程中采用常规方式对A组患者进行护理;采用针对性综合护理方法对B组患者进行护理。对两组患者经过治疗和护理后的病情的改善情况、用药治疗的安全性和病情再复发情况进行比较分析。1.3 疗效评价标准显效：经过治疗后患者虽然仍然存在轻微的神经功能障碍，但已经基本可以进行正常生活;有效：治疗后患者处于中度病残状态，但是生活已经基本可以自理;无线：治疗后患者处于重度病残状态，生活无法自理，意识清楚或植物人亦或死亡。1.4 数据处理

5、在研究的整个过程中得到相关数据，均采用常用的SPSS14.0数据处理系统予以处理，当P<0.05时，可以认为有明显统计学差异。2 结果经过仔细研究后我们发现，B组患者在治疗和护理后所取得效果明显优于A组患者，且有非常明显的统计学差异(P<0.05);该组患者的治疗的安全性明显高于A组患者，且有非常明显的统计学差异(P<0.05);该组患者治疗后出现再出血现象的人数明显少于A组患者，且有非常明显的统计学差异(P<0.05)。3 讨论主要采用以下几种方法对该类患者予以护理：一般护理：尽量少进行运动,最好是卧床进行休息, 患者意识不清时采取侧卧或者是头偏向一侧,床头抬高15-

6、30度左右的角度,这样会对静脉回流产生一定的推动作用,缓解脑水肿, 在床上应安置床栏,避免患者出现坠床的现象;对探视的人员数量等进行限制, 使病房保持安静,减少一些不必要的不良刺激;口腔以及皮肤护理要尽量做到最好,使呼吸道可以保持通畅,避免出现误吸的现象;使皮肤保持清洁, 减少长期局部受压的现象,避免压疮的出现;再出去进行一些检查或者是在转运的过程中, 应该让护士予以亲自护送,若有需要医生也应陪在身边护送。心理护理：因为发生脑出血症状十分的突然, 患者及其家属都会感到很紧张,又由于紧张情绪会使患者的颅内压不断升高。所以,需要对患者予以心理安慰以及疏导,对可能引起呕吐、头痛等症状的原因、一些辅助

7、的检查以及疾病的转归等向患者进行详细的解释, 使患者紧张以及恐惧等情绪得到缓解,防止出现一些不良心理而导致血压增高使病情加重。血压控制：救治成功的关键是对合理水平的血压进行维持。给予必要的心电监护,对血压进行连续监测,在应用抗高血压药物时应遵照医嘱,血压最好维持在150-160/90-100mmHg左右,大多数情况下1天之内下降幅度最好小于或等于30mmHg。病情观察：对瞳孔大小以及对光的反射等情况进行严密的观察, 对呼吸、脉搏、血压等进行检测,对恶心、头痛、呕吐等情况应予以注意,若是有意识障碍或者是意识障碍加深、对光反射减弱或者是消失、一侧瞳孔出现散大、脉搏缓慢且洪大、血压升高、呼吸慢且浅等

8、状况出现时, 要警惕是否出现了脑疝,应马上通知医生,予以积极有效的处理。在应用利尿剂以后,心率或者是脉搏没有发生变化, 尿量也没有增加, 血中的尿素氮、肌酐以及血钾均有显著的增高,这些现象的发生都揭示出肾功能发生了衰竭,立即通知医生，进行有效的处理。出院指导：患者患病时间较长, 脑功能会出现一定程度的损伤, 在患者出院时对患者进行康复训练的指导, 嘱咐患者在进行训练时要循序渐进，并且做到持之以恒, 使生活自理能力逐步的恢复, 使生存质量得到提高;尽量减少情绪激动等现象,使心态保持正常的状态;饮食方面要注意使用一些清淡的食物,饮食要规律，大便保持通畅，定期进行复查。总而言之，应用内科保守治疗法对

9、高血压脑出血的患者进行治疗，并在治疗后对其进行针对性的综合护理，可以使该类患者治疗所取得效果明显提高，使治疗的安全性和彻底性得到更好的保证，可进一步使用推广。QcWA3PtGZ7R4I30kA1DkaGhn3XtKknBYCUDxqA7FHYi2CHhI92tgKQcWA3PtGshLs50cLmTWN60eo8Wgqv7XAv2OHUm32WGeaUwYDIAWGMeR4I30kA1DkaGhn3XtKknBYCUDxqA7FHYi2CHhI92tgKQcWA3PtGZ7R4I30kA1DkaGtgKQcWA3P tGZ7R4I30kA1DkaGhn3XtKknBYCUDxqA7FHYi2C

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