Abstract
BackgroundWe sought to explore an optimal clinical nursing mode following a hybrid surgery for cerebral arteriovenous malformation.MethodsPatients with complex cerebral arteriovenous malformations seen in our neurosurgery department from January 2016 to December 2017 were prospectively enrolled. The hybrid surgery protocol included “angiographic diagnosis, surgical resection, and intraoperative angiographic evaluation” and “angiographic diagnosis and embolization, surgical resection, and intraoperative angiographic evaluation”. The patients were randomly stratified into intensive care group and routine care group. After surgery, intensive or routine care was provided, and the prognosis of patients was evaluated, with a subsequent comparative analysis.ResultsA total of 109 cases were divided into the routine nursing group (n = 54 cases) and intensive nursing group (n = 55 cases). There were no significant differences between the two groups in baseline data before surgery. Postoperative lung infection in the intensive nursing group was significantly less frequent than those in the routine nursing group (5.5% vs. 18.5%, P=0.039) with pulmonary infection and lower extremity venous thrombosis (5.5% vs. 24.1%, P=0.006). The average hospital stay in the intensive nursing group was 14.4 ± 5.78 days, which was significantly lower than that in the routine nursing group (19.3 ± 6.38 days, P=0.013). At 3 months’ follow-up after surgery, the Generic Quality of Life Inventory-74 (GQOLI-74) dimension score and GQOLI-74 total score in the enhanced group were significantly better than those in the routine nursing group (P=0.017 and 0.023, respectively).ConclusionsIntensive postoperative nursing can improve the safety of patients after hybrid surgery, reduce the postoperative complications and the average length of hospital stay, and improve the quality of life of patients.
Highlights
We sought to explore an optimal clinical nursing mode following a hybrid surgery for cerebral arteriovenous malformation
Baseline data of the study population From January 2016 to December 2017, 109 patients with complex cerebral arteriovenous malformations were treated in our ward by hybrid surgery, including 60 males and 49 females aged 9 to 54 years
All of the patients were confirmed as having giant arteriovenous malformation by imaging examination
Summary
We sought to explore an optimal clinical nursing mode following a hybrid surgery for cerebral arteriovenous malformation. The main steps of the hybrid operation for the treatment of cerebral arteriovenous malformations include (1) preoperative angiography of the whole cerebral artery, (2) preoperative embolization, (3) angiography reexamination of embolization results, (4) craniotomy for the removal of vascular malformations, (5) angiography reexamination of the surgical results, and (6) adequate hemostasis followed by craniotomy. The blood supply of complex cerebral arteriovenous malformations is abundant, which results in chronic hypoperfusion of the surrounding brain tissue. After resection or embolization of arteriovenous malformations, the normal brain tissue that has been adapted to low perfusion appears damaged in terms of its ability to self-regulate changes in blood pressure and carbon dioxide. This study investigated the method and value of enhanced perioperative nursing care for patients with hybrid surgery for complex cerebral arteriovenous malformations
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