摘要:
Objective To explore the clinical efficacy and the influence for hydrocephalus of clinical nursing pathway on side ventricular drainage treatment of spontaneous intracerebral hemorrhage ( ICH) in children. Methods A total of 72 ICH children admitted to the hospital from January 2013 to October 2017 and treated with lateral ventricular drainage were reviewed. Among them, 34 cases of children with ICH who received routine care from January 2013 to January 2015 were labeled as the control group, and 38 cases of children who received combined clinical care on the ba-sis of routine care from January 2015 to October 2017 were labeled as the observation group. All the children were trea-ted with lateral ventricular drainage, and the differences in perioperative indicators such as duration of drainage, re-moval time of drainage hematoma and so on were compared between the two nursing modes. Patients were followed up for 6 months after treatment, and the incidence of complications such as hydrocephalus, intracranial infection and re-hemorrhage after treatment were compared between the two groups and 3 months and 6 months after treatment, National Institute of Health Stroke Scale ( NIHSS) , the Barthel Index of ADL and Intracerebral Hemorrhage-Ⅱ( ICH-Ⅱ) score differences were compared. In addition, the nursing satisfaction of the patients'families was investigated to analyze the differences in the satisfaction of the patients'families under the two nursing modes. Results There was no significant difference in the duration of drainage, drainage volume, hematoma clearance rate, and drainage tube removal time be-tween the two groups ( P>0. 05) . The incidence of hydrocephalus in the observation group was significantly lower than that in the control group, and difference was statistically significant (P0. 05) . The total incidence of complications in the observation group was sig-nificantly lower than that in the control group, and the difference was statistically significant ( P0. 05). At 3 months and 6 months after treatment, the NIHSS, ICH-Ⅱscore of the two groups was significantly lower than that before treatment, and the Barthel score was significantly higher than that before treatment. Moreover, the score for NIHSS, ICH-Ⅱof the observation group were significantly lower than those of the control group at 3 months and 6 months after treatment, the Barthel score was significantly higher than the control group, and the differences were statistically significant ( P0. 05) .观察组治疗后脑积水发生率明显低于对照组,差异有统计学意义(P0. 05);观察组患儿治疗后并发症总发生率显著低于对照组患儿,差异有统计学意义(P0. 05);两组患儿治疗后3个月、6个月NIHSS、ICH-Ⅱ评分显著低于治疗前,Barthel评分显著高于治疗前,且观察组患儿治疗后3个月、6个月NIHSS、ICH-Ⅱ评分显著低于对照组,Barthel评分显著高于对照组,差异均有统计学意义(均P<0. 05).观察组患儿护理总满意度显著高于对照组,差异有统计学意义( P<0. 05) .结论 临床护理路径在ICH患儿侧脑室引流治疗中的应用效果显著,能有效降低患者治疗后脑积水发生率,改善神经功能,降低再出血风险,患儿家属就诊满意度更高,值得临床推广应用.