eCASH护理模式对老年病人髋部术后谵妄的影响  

Effect of eCASH nursing model on postoperative delirium in elderly patients with hip surgery

作　　者：陈淑芳[1] 李伯恩[1] 营霞 张先棠[1] 石秀峰[1] CHEN Shu-fang LI Bo-en YING Xia ZHANG Xian-tang SHI Xiu-feng(Department of Orthopaedics, The Second Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 23040, Chin)

机构地区：[1]蚌埠医学院第二附属医院骨科,安徽蚌埠233040

出　　处：《蚌埠医学院学报》2017年第7期983-986,共4页Journal of Bengbu Medical College

摘　　要：目的:探讨e CASH护理模式对老年髋部病人术后谵妄发生的影响。方法:将2016年8-11月骨科收治的30例老年髋部手术病人作为对照组;2016年12月至2017年3月收治的32例老年髋部病人作为观察组。对照组行常规骨科术后护理,观察组实施e CASH护理管理,术后3 d内护士每天运用Nu-DESC评估,比较2组病人术后发生谵妄情况、2组病人不同时间点疼痛视觉模拟(VAS)评分、2组病人住院时间及2组病人术后恶心呕吐、非计划拔管等不良反应发生率。结果:2组病人术前均有不同程度疼痛,但差异无统计学意义(P>0.05),2组术前均无谵妄,2组病人术后不同时点(术后24 h、48 h、72 h)谵妄程度评分比较,观察组术后发生谵妄程度明显低于对照组(P<0.01),观察组术后不同时间点VAS评分均明显低于对照组(P<0.01);2组住院时间对比,观察组住院时间明显低于对照组(P<0.01);2组病人术后恶心呕吐及非计划拔管等不良反应发生率观察组明显低于对照组(P<0.01)。结论:对老年髋部病人术后实施e CASH护理模式,早期给予有效的镇痛,一切以病人的舒适为中心,有利于减低老年髋部病人术后谵妄发生,降低老年髋部术后病人住院时间,减少老年髋部病人术后恶心呕吐及非计划拔管等不良反应的发生率,为预防老年髋部病人术后并发症提供有效依据。Objective：To investigate the effects of eCASH nursing model on postoperative delirium in elderly patients with hip surgery. Methods：Thirty elderly patients with hip surgery from August to November in 2016 and 32 elderly patients with hip surgery from December 2016 to March in 2017 were divided into the control group and observation group,respectively. The control group and observation group were treated with the routine postoperative nursing and eCASH nursing management, respectively. All cases were evaluated using Nu-DESC within postoperative 3 days. The delirious state,VAS scores at different time-points,hospitalization time,and incidence rates of nausea and vomitting and unplanned extubation between two groups were compared after operation. Results：The different degrees of pain in two groups were identified before operation,but the difference of which was not statistically significant（ P〉0. 05）. There was no delirium in the 2 groups before operation. The delirious scores in observation group after 24,48 and 72 hours of operation were significantly lower than those in control group（P〈0. 01）. The VAS scores at different time-points of postoperation, hospitalization time and incidence rates of nausea and vomitting and unplanned extubation in observation group were significantly lower than those in control group（P〈0. 01）. Conclusions：The eCASH nursing model and early effective analgesia can effectively reduce the occurrence of postoperative delirium, hospitalization time and incidence rates of postoperative nausea and vomiting and unplanned extubation,which can provide the effective basis in preventing the postoperative complications in elderly patients with hip surgery.

关 键 词：术后谵妄 髋部手术 镇痛护理理念 

分 类 号：R473.6[医药卫生—护理学]