ICU专科术前访视对老年择期手术病人术后影响  

PREOPERATIVE INTERVIEW:ITS EFFECT ON ELDERLY PATIENTS AFTER SURGERY

作　　者：宋砚坤 胡丹[1] 满孝云 王奉涛[1] 刘海燕[1] 

机构地区：[1]青岛大学附属青岛市市立医院重症医学科,山东青岛266011 [2]青岛大学护理学院

出　　处：《齐鲁医学杂志》2016年第6期724-726,728,共4页Medical Journal of Qilu

摘　　要：目的了解ICU专科术前访视对降低老年择期手术病人术后谵妄发生率、增加病人配合度、提高护理满意度的效果。方法选取行择期手术并术后入住ICU的老年病人92例,随机分为两组,对照组43例,访视组49例。对照组病人术前由手术室和病房护士进行常规术前护理和健康教育,术后在ICU采用常规措施予以护理;访视组病人在此基础上,由ICU专职护士进行ICU专科术前访视。比较两组病人术后谵妄发生率、机械通气时间、对护理工作的配合程度及满意度的差异。结果访视组术后谵妄发生率低于对照组,差异有显著性（χ^2=6.02,P〈0.05）;机械通气时间和入住ICU的时间短于对照组,差异有显著性（t=2.20、2.19,P〈0.05）。两组护理工作配合程度指标中非计划性拔管率及要求进食水率比较差异无显著性（P〉0.05）,其他配合程度指标及对护理工作满意度差异均有显著性（χ^2=5.84~11.48,uc=3.016,P〈0.05）。结论 ICU专科术前访视能降低老年择期手术病人术后谵妄发生率,提高病人对术后ICU护理配合度及护理工作的满意度。Objective To investigate the effect of preoperative ICU interview on postoperative delirium, cooperation and increase of nursing satisfaction on elderly patients scheduled for selective surgery. Methods Ninety-two elderly patients scheduled for selective surgery and would stay in ICU after operation were divided into control group （n=43） and interview group （n=49）. Patients in the control group received routine preoperative nursing and health education provided by operating room and ward nurses, and received conventional nursing in ICU after surgery, those in the interview group received preoperative ICU interview, conducted by specialist nurses, in addition to that carried out in the control group. The differences in postoperative delirium, mechanical ventilation time, coordination degree and satisfaction degree on nursing work between the two groups were compared.Results Compared with the control group, the incidence of postoperative delirium was lower in the interview group （χ^2=6.02,P〈0.05）, the mechanical ventilation time and ICU stay were shorter （t=2.20,2.19;P〈0.05）.In nursing work coordination indexes, the difference in unplanned extubation rate and water consumption rate between the two groups was not significant （P〉0.05）, and the differences in other coordination indexes and nursing work satisfaction were significant between the two groups （χ^2=5.84-11.48,uc=3.016,P〈0.05）. Conclusion Preoperative visit can reduce the incidence of postoperative delirium in elderly patients scheduled for selective surgery, and improve their coordination after surgery and satisfaction with the nursing work.

关 键 词：重症监护病房 手术前护理 老年人 谵妄 

分 类 号：R472[医药卫生—护理学]