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Intracranial aneurysms postoperative continuous lumbar drainage of cerebrospinal fluid a large pool of nursing

Another important reason,[link widoczny dla zalogowanych], in the nursing work, we deal with patients and their families in the church to enhance drainage tube care, bed activities, range of motion should not be too large, avoid drainage tube compression, bending, etc., to take the initiative to meet and maintain an effective drainage ; For unconscious patients, should be properly bound, and step up inspections. There were 2 patients in this group due to go out to check the drainage tube clamped for too long, check back after wards found that drainage of less smooth, the other found in 1 case the third day of drainage fluid drainage suddenly stops flowing, consider the pipes get clogged, I Jinie after all flow. 2.3.4 the amount of drainage and speed control under normal circumstances, the general adult daily fluid can produce about 500ml. Sustained a large number of cerebrospinal fluid drainage, the subarachnoid space collapse, bloody cerebrospinal fluid can not be washed away, and cerebral vasospasm-related chemicals remain in the arteries around, easy to cause cerebral vasospasm, cerebral infarction. Meanwhile, the over-drainage of cranial pressure often can cause disease, headaches caused by intracranial hypotension, and intracranial CSF suppression has led to increased secretion, reducing the absorption, which may induce hydrocephalus, more serious problem can be caused by intracranial hematoma, the incidence of brain herniation L2]. Therefore,[link widoczny dla zalogowanych], strict control of drainage is particularly important: (1) close observation of the amount of drainage, drainage prescribed to maintain no more than a day 350ml. According to adjust the drainage bag drainage height. Under normal circumstances, the bottom of the drainage bag should be higher than lumbar puncture 1O ~ 15cm, when the patient changes body position, head height is changed, should be re-adjusting the height of drainage bag to prevent excessive lead 9O7 · flow; (2) Initial drainage of cerebrospinal fluid due to viscous Erzhi bloody slow drainage, less the amount, and in the latter part of the drainage of cerebrospinal fluid to gradually turn pale yellow clear, and the exclusion of other factors, its characters more drainage, the drainage rate relative to speed up, so different in the process of care should be based on the characteristics of drainage focused observation; (3) the process of continuous external drainage to maintain uniform pay special attention to prevent the sudden drainage of large changes in velocity, intracranial pressure caused a greater moment fluctuations lead to severe complications such as hernia; (4) drainage process should avoid sudden and sharp increase in intracranial pressure caused by excessive drainage, Zhu Huanzhe keep warm to prevent cold, cough, hard to avoid; maintain smooth stool, avoiding hard, eating light easy to digest, the appropriate use of laxatives; maintain emotional stability. This group of patients, 1 patient with sitting a long time, headache, nausea, dizziness and a sense of private prosecution has given supine rest, relieved by elevation drainage bag. 2.3.5 Prevention of infection in lumbar drainage tube placed easily lead to intracranial infection too long. Nursing care should be observed in the drainage of fluid characteristics, daily routine and biochemical cerebrospinal fluid examination, on a regular basis increases susceptibility test for bacterial culture, daily monitoring of body temperature. Such as the drainage of turbid fluid, cerebrospinal fluid examination revealed increased protein, increased cell number and classification,[link widoczny dla zalogowanych], while patients with moderate fever, suggestive of intracranial infection. Tube should be kept clean and dry parts of the dressing, to observe whether the catheter site skin redness, swelling or leakage and other abnormal puncture point, daily disinfection of the puncture point, change dressings, sweating more, the dressing change at any time. Strict aseptic injection and flushing operation. Moving patients, dumping drainage fluid drainage when the first three links clamping screw valve to prevent fluid reflux. Control extubation, extubation time, to reduce the incidence of infection. The group of 32 patients after careful observation and care, no intracranial infection. 2.3.6 Strict time to extubation of cerebrospinal fluid clean and clear, protein decreased cell count normal,[link widoczny dla zalogowanych], it is timely drainage tubes were removed. If early removal, bloody fluid and cerebrospinal fluid concentrations of decomposition products is still high, you can not mitigate the cerebral stimulation; red blood cells into the arachnoid granulations with CSF, which block the production of communicating hydrocephalus, lumbar puncture and re-set to be done tube, thereby increasing the burden on the patient's pain and thoughts. This group of patients, 1 case of catheter 14d extubation, after extubation occurred communicating hydrocephalus 3d, to re-tube.
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