What are the preoperative preparations and postoperative care for cerebral aneurysm embolization?

What are the preoperative preparations and postoperative care for cerebral aneurysm embolization?

Research has found that active and effective preparation before surgery, early prevention after surgery, early detection, and early treatment of complications are important conditions for the success of cerebral aneurysm embolization.

1. Preoperative preparation

1. After an intracranial aneurysm ruptures and bleeds, while waiting for surgery, the patient should be given treatment measures such as lowering blood pressure, cooling, reducing intracranial pressure, anti-cerebral vasospasm, anti-fibrinolysis and external ventricular drainage, and actively create conditions to implement intravascular embolization therapy.

2. Other preparations for the patient:

1. Take a detailed medical history, conduct a comprehensive physical examination and a systematic neurological examination.

2. Patients with a history of epilepsy should be treated with anti-epileptic drugs before surgery.

3. Before surgery, CT plain scan plus enhanced scan, MRI, and MRA examinations are performed according to the condition.

4. Before the operation, blood and urine routine tests, bleeding and coagulation time, liver and kidney function, chest X-ray, heart and electroencephalogram tests, etc. are performed.

5. Fasting before surgery, iodine allergy test, skin preparation of puncture site such as perineum, and indwelling urinary catheter.

2. Postoperative Care

1. Perform routine postoperative care for cerebral angiography.

2. For those who retain the arterial sheath after surgery, close observation should be performed to prevent sheath dislocation, strict immobilization of the lower limb on the operated side should be implemented, and guidance should be provided to the patient and his family.

3. Remove the sheath 8 hours after surgery. After the removal of the tube, apply local manual pressure to the puncture site for 30 minutes. Then apply pressure with a pressure bag for 6 hours, and immobilize the lower limbs on the surgical side for 24 hours. After 24 hours, you can move around in bed. You can get out of bed and move around appropriately 48 hours after surgery. The movements should be slow and avoid sudden force. Avoid heavy physical labor within one week after surgery to prevent wound bleeding.

4. Closely observe the patient's vital signs, pay special attention to the dynamic changes of blood pressure, control blood pressure at 70-80/110-130 mmHg, and prevent complications related to interventional surgery.

5. Closely observe the puncture site for bleeding, congestion and hematoma, monitor the skin color, temperature, sensation, dorsalis pedis artery pulsation of the affected limb every hour, and report any abnormalities promptly.