老年病人术后谵妄相关因素分析及其护理  

Analysis on related factors of postoperative delirium of senile patients and nursing strategies for them

作　　者：方向红[1] 鲁刚[1] 王金菊[1] 罗小玲[1] 朱立亚[1] 

机构地区：[1]广东医学院附属福田人民医院(深圳市第四人民医院)

出　　处：《全科护理》2010年第9期753-755,共3页Chinese General Practice Nursing

摘　　要：[目的]探讨引起老年病人术后谵妄的原因及相应的护理对策。[方法]统计1998年1月—2009年6月60岁以上病人,记录68例术后谵妄病人的术前疾病、手术种类、术中及术后用药等,并控制环境因素、心理因素、疼痛因素、药物因素、体位因素等,在术前、术后、出院后进行全方位的护理。[结果]发生术后谵妄的老年病人中术前有各种内科疾病的占100%,术前用药中阿托品占95.6%,甲硝唑占86.8%,胃肠外营养(TPN)占63.2%。针对这些影响因素采取护理措施后,68例病人24h至1周内好转,绝大多数3d内好转。[结论]老年术后谵妄与术前已存内科疾病、术前使用阿托品、甲硝唑等用药及胃肠外营养等有关。应明确各种高危因素并采用相应细致的护理措施。Objective： To probe into causes of postoperative delirium of senile patients and comprehending nursing strategies. Methods=A total of 68 inpatients aged 60 years old or above with postoperative delirium were selected from January 1998 to June 2009. Preoperative disease,operation category,medication during and after operation of all cases had been recorded. And factors of environment, psychology, pain, drug, and posture and so on were controlled. Then all patients were given omnibearing nursing care pre - post- operation and after discharge. Results： Before operation, 100% patients had various internal medical diseases. Among preoperative medication,95.6% of cases had been given atropine,86.8% had been given metronidazole,and 63.2% had been given TPN. After adopting targeted nursing measures,all patients have a good recovery after 24 hours to one week. Most of them improved within 3 days. Conclusion： Postoperative delirium in elderly patients was related to their internal medical illness, the usage of atropine or metronidazole or TPN before operation. All high risk factors should be identified and comprehending careful nursing measures should be adopted for them.

关 键 词：老年人 术后谵妄 护理干预 

分 类 号：R473.6[医药卫生—护理学]