集束化护理方案对缺血型烟雾病搭桥术后 并发症预防的效果分析
摘要
用单中心回顾性队列研究，纳入2021年1月至2024年12月在我院接受脑血流重建术的163例缺血型烟雾病患者。依
据护理依从性评分分为高依从组（n=98）与低依从组（n=65），比较两组护理过程质量、术后并发症及术后6个月
神经功能结局（改良Rankin量表[mRS]评分≤1为预后良好），并行多因素回归分析。结果：高依从组在血压控制达
标率（89.8% vs 67.7%）、神经功能评估完成率（91.8% vs 75.4%）及24小时内抗血小板治疗执行率（95.9% vs 83.1%）
上均显著更优（P<0.05）。高依从组脑高灌注综合征（7.1% vs 16.9%）和新发神经功能缺损（9.2% vs 20.0%）发生率
显著更低（P<0.05）。术后6个月良好神经功能结局比例（79.6% vs 69.2%）组间无显著统计学差异（P=0.098）。多
因素分析显示，血压控制达标是良好预后的独立保护因素（OR=2.26），而未及时抗血小板治疗是独立危险因素
（OR=0.30）。结论：应用集束化护理能显著提升护理质量，有效降低高灌注综合征等关键术后并发症风险。精准血
压管理与及时抗血小板治疗是改善预后的关键环节。
关键词
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