Discussion on postoperative nursing of ventriculostomy and drainage.
Answer: Nursing care after ventriculostomy and drainage is very important, especially the following points. (1) properly fix the drainage tube: the opening of the drainage tube is higher than the lateral ventricle plane 10 ~ 15 cm to maintain normal intracranial pressure. (2) Control drainage: record the outflow of cerebrospinal fluid every day, and control the drainage volume to be less than 500mL every day to keep the intraventricular pressure within the normal range. Because when the ventricle is obviously enlarged, a large amount of cerebrospinal fluid is drained in a short time, and the intracranial pressure suddenly drops, which can collapse the cerebral cortex and tear the bridging vein from the cortex to the sagittal sinus, resulting in subdural hematoma; Or an epidural hematoma caused by dural collapse. (3) Observe the characteristics of cerebrospinal fluid: Normal cerebrospinal fluid is colorless and transparent without precipitation. If there is a lot of blood in cerebrospinal fluid after operation, it often indicates intraventricular hemorrhage. If the cerebrospinal fluid is turbid or flocculent, suggesting intracranial infection, cerebrospinal fluid samples should be sent for examination according to the doctor's advice. (4) Keep the drainage tube unobstructed: the drainage tube shall not be compressed, twisted or angled, so as not to block the cerebrospinal fluid circulation and cause acute intracranial pressure increase. The patient's head movement should be properly restricted, and the drainage tube should not be pulled when turning over and operating. (5) Prevention of infection: When the wound dressing is wet or contaminated, report it to the doctor immediately and replace it in time. When replacing the drainage tube, the drainage tube should be clamped first to prevent cerebrospinal fluid from flowing back into the ventricle, and the operation should be strictly sterile. (6) Key points of extubation: The drainage time is generally 3-4 days. Clamp the drainage tube for 24 hours before extubation, and closely observe whether there is increased intracranial pressure.