PDF(Pubmed)
Abstract：
Traumatic subarachnoid hemorrhage (tSAH) is a critical condition that requires comprehensive management to optimize patient outcomes. Nursing care plays a key role in the overall management of patients with tSAH via various aspects of care, including neurological assessment, monitoring, intervention, and education. In this review, we aim to evaluate the significant contributions of nursing care in managing patients with tSAH. Nurses perform initial neurological assessments, including the glasgow coma scale, pupil reactivity, vital signs, and sensory-motor evaluations. These assessments provide valuable information for early identification of deteriorating neurological status and prompt intervention. Additionally, nurses closely monitor intracranial pressure (ICP), cerebral perfusion pressure, and other hemodynamic parameters, assisting in the prevention and timely detection of secondary brain injury. For example, some strategies to manage ICP include elevating the head of the bed, maintaining adequate oxygenation and ventilation, administering proper medications, and ensuring fluid and electrolyte balance. Also, through careful monitoring, early recognition, and appropriate preventive measures, nursing care could prevent complications, including infections, deep vein thrombosis, and pressure ulcers. Furthermore, nursing care extends beyond physical management and encompasses psychosocial support for patients and their families. Nurses establish therapeutic relationships, providing emotional support, education, and counseling to alleviate anxiety, address concerns, and facilitate coping mechanisms. Education regarding medication management, lifestyle modifications, and the importance of regular follow-up enhances patient compliance and promotes long-term recovery.
摘要：
创伤性蛛网膜下腔出血（tSAH）是一种危重症，需要综合管理以优化患者预后。护理在tSAH患者的整体管理中起着关键作用，通过各个方面的护理，包括神经学评估,监测,干预，和教育。在这次审查中,我们旨在评估护理在管理tSAH患者方面的重要作用.护士进行初步的神经学评估,包括格拉斯哥昏迷量表,瞳孔反应性,生命体征,和感觉运动评估。这些评估为早期识别恶化的神经状态和及时干预提供了有价值的信息。此外,护士密切监测颅内压（ICP），脑灌注压,和其他血液动力学参数，协助预防和及时发现继发性脑损伤。例如,管理ICP的一些策略包括抬高床头，保持足够的氧合和通风，管理适当的药物，并确保流体和电解质平衡。此外，通过仔细监测,早期识别,和适当的预防措施，护理可以预防并发症，包括感染,深静脉血栓形成,和压疮。此外，护理超越了身体管理，包括对患者及其家人的社会心理支持。护士建立治疗关系，提供情感支持,教育,和缓解焦虑的咨询，解决关切，并促进应对机制。关于药物管理的教育，改变生活方式,定期随访的重要性提高了患者的依从性并促进了长期康复。
