ISSN 2097-6046(网络)
ISSN 2096-7446(印刷)
CN 10-1655/R
主管:中国科学技术协会
主办:中华护理学会

中华急危重症护理杂志 ›› 2026, Vol. 7 ›› Issue (11): 1344-1347.doi: 10.3761/j.issn.2096-7446.2026.11.011

• 重症护理研究 • 上一篇    下一篇

阿尔茨海默病合并低颅压性脑积水患者的分阶段护理

丁灵(), 俞平*()   

  1. 浙江省人民医院/杭州医学院附属人民医院康复中心神经外科 杭州市 310014
  • 收稿日期:2025-11-28 出版日期:2026-11-10 发布日期:2026-11-06
  • 通讯作者: *俞平,E-mail:69291262@qq.com
  • 作者简介:丁灵:女,本科,护师,E-mail:983363511@qq.com
    作者贡献声明

    丁灵:数据收集、循证分析、论文撰写;俞平:论文审阅、研究指导

Staged nursing management for a patient with Alzheimer disease complicated by low-pressure hydrocephalus

DING Ling(), YU Ping*()   

  1. Center for Rehabilitation Medicine, Department of Neurosurgery,Zhejiang Provincial People’s Hospital/Affiliated People’s Hospital,Hangzhou Medical College, Hangzhou 310014, China.
  • Received:2025-11-28 Online:2026-11-10 Published:2026-11-06
  • Contact: *YU Ping,E-mail:69291262@qq.com

摘要:

总结1例阿尔茨海默病合并低颅压脑积水患者的护理体会。在精准鉴别可逆性与不可逆性认知障碍的前提下,借助多学科团队协作,共同制订并施行“初始稳定—顺应性重建—康复改善”三阶段护理策略。主要护理举措涵盖基于适度提升灌注压的体位与血压管理、加压腹带的应用、动态调压的脑室外引流,以及认知训练、排便训练等个性化干预手段。患者住院期间,神经功能与认知能力呈逐步改善态势,脑室形态恢复至正常水平,未出现并发感染情况。患者住院期间,简易精神状态检查量表评分由10分升至18分,日常生活活动能力评分由45分升至70分,失禁频率由完全失禁降至每日少于1次。患者入院第56天康复出院。

关键词: 低颅压性脑积水, 阿尔茨海默病, 脑室外引流, 分阶段护理, 危重病护理

Abstract:

To summarize the nursing experience in a patient with Alzheimer disease complicated by low-pressure hydrocephalus. After differentiation reversible from irreversible cognitive impairment,a multidisciplinary team formulated and implemented a three-stage nursing strategy of initial stabilization,adaptive reconstruction and rehabilitative improvement. Key interventions included positioning and blood pressure management aimed at gently increasing cerebral perfusion pressure,application of an abdominal binder,dynamically titrated external ventricular drainage,and individualized measures such as cognitive and bowel training. During hospitalization,the patient’s neurological and cognitive functions improved progressively. Ventricular morphology returned to normal,and no infectious complications occurred. The Mini-Mental State Examination score increased from 10 to 18,the ADL score improved from 45 to 70,and urinary incontinence decreased from complete incontinence to fewer than one episode per day. The patient was discharged after 56 days with significant functional recovery.

Key words: Low-Pressure Hydrocephalus, Alzheimer Disease, External Ventricular Drainage, Staged Nursing, Critical Care Nursing