护理干预对老年髋部骨折患者术后谵妄的效果观察  

Effect of nursing intervention on postoperative hip disorder in elderly patients with hip fracture

作　　者：董芳辉[1] 胡三莲[1] 岳慧玲[1] 董文君[1] 

机构地区：[1]上海交通大学附属第六人民医院骨科,200233

出　　处：《中华关节外科杂志（电子版）》2017年第5期46-49,共4页Chinese Journal of Joint Surgery(Electronic Edition)

基　　金：上海交通大学医学院科技基金项目(JYH1716)

摘　　要：目的探讨积极的护理干预对老年髋部骨折患者术后谵妄的影响。方法选取2015年7月至2016年12月在上海市第六人民医院创伤外科住院的老年髋部骨折患者124例为研究对象。纳入标准为年龄≥60岁,且患者及家属同意参加本研究;排除标准为经体格检查及脑部CT扫描存在临床颅脑器质性病变,合并严重老年痴呆,既往有精神疾病史,既往有滥用精神类药物和酒精史。将2015年7月至2016年3月入组的62例患者设为对照组,采用常规护理方法;2016年4月至2016年12月入组的62例患者为干预组,在常规护理的基础上采用评估干预等护理措施。利用卡方检验比较干预方案实施后的谵妄发生率,患者的满意率;利用t检验比较两组患者平均住院时间。结果护理干预组谵妄的发生率明显低于常规护理组(2=10.83,P<0.05),平均住院时间均低于常规护理组(t=3.29,P<0.05),患者的满意率高于对照组(2=4.211,P<0.05)。结论护理干预能有效地降低老年髋部骨折患者术后谵妄的发生率,减少住院时间,提高患者的满意率。Objective To investigate the effect of positive nursing intervention on postoperative delirium after hip surgery in elderly patients. Methods From July 2015 to December 2016,124 elderly patients with hip fractures in the Department of trauma surgery in Shanghai No. 6 People＇ s Hospital were selected. The inclusion criteria were 60 years of age or older,and the patients and their family members agreed to participate in this study; Exclusion criteria included physical brain examination and brain CT scan,clinical brain organic lesions,severe Alzheimer＇s disease,history of mental illness,history of abuse of psychotropic drugs and alcohol. From July 2015 to March 2016,62 cases were enrolled into the control group,using conventional methods of nursing. From April 2016 to December 2016,62 patients were enrolled into the intervention group and adopted routine care on the basis of the evaluation of the intervention and nursing measures. The chi-squaretest was used to compare the incidence of delirium and the satisfaction rate of the patients after the intervention program. The t test was used to compare the average length of stay between the two groups. Results The incidence of delirium in the nursing intervention group was significantly lower than that in the routine nursing group（ 2= 10. 83,P〈0. 05）,and average length of stay in the nursing intervention group were lower than the routine nursing group（ t = 3. 29,P〈0. 05）,and the satisfaction rate was higher than the control group（ 2= 4. 211,P〈0. 05）. Conclusion Implementation of the delirium nursing intervention program can effectively reduce the incidence of postoperative delirium in elderly hip fracture patients,decrease the hospital stay and improve the patient satisfaction rate.

关 键 词：老年人 髋骨折 谵妄 护理 

分 类 号：R473.6[医药卫生—护理学]