基于住院老年人生活项目的多学科综合干预模式预防术后谵妄的效果  

Effects of Hospital Elder Life Program-based interdisciplinary intervention on prevention of postoperative delirium in the elderly

作　　者：邓传瑶 王艳艳[1] 谢冬梅[1] 高浪丽[1] 岳冀蓉[1] DENG Chuan-yao;WANG Yan-yan;XIE Dong-mei;GAO Lang-li;YUE Ji-rong(Center of Gerontology and Geriatrics,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院老年科,四川省成都市610041

出　　处：《实用老年医学》2019年第1期12-15,共4页Practical Geriatrics

基　　金：国家重点研发计划重点专项课题(2017YFC0840100;2017YFC0840101);四川省科技计划资助(2018SZ0252;2018JY0094)

摘　　要：目的验证基于住院老年人生活项目(Hospital Elder Life Program,HELP)的多学科综合干预模式预防老年病人术后谵妄的效果。方法 281例年龄≥70岁外科病房择期手术病人,随机分为试验组(152例)和对照组(129例),试验组给予基于HELP的多学科综合干预,对照组给予常规照护方案。比较2组术后7 d内谵妄的发生率、谵妄严重程度、住院时间、病人满意度及不良事件。结果试验组谵妄发生率显著低于对照组(2. 8%比20. 6%,P<0. 001);进一步意向性分析显示,试验组谵妄发生率仍显著低于对照组(10. 5%比19. 4%,P<0. 05)。试验组平均住院时间显著少于对照组[(12. 15±3. 78) d比(16. 41±4. 69) d,P<0. 05],满意度高于对照组[(94. 44±6. 29)分比(85. 07±5. 72)分,P<0. 05]。结论基于HELP的多学科综合干预模式能够降低老年病人术后谵妄的发生率,并能缩短住院时间,提高病人满意度。Objective To examine the effects of Hospital Elder Life Program(HELP)-based interdisciplinary intervention on postoperative delirium. Methods A total of 281 elderly patients undergoing elective surgery in surgical wards aged 70 years and over were randomly divided into the test group(n = 152) and the control group(n = 129). The test group was given HELP-based interdisciplinary intervention and the control group was given routine care regimen. The incidence rate of delirium,the severity of delirium, average hospitalization days, patients’ satisfaction, and adverse events were compared between the two groups within 7 days after surgery. Results The incidence rate of delirium after surgery was significantly lower in the test group than that in the control group(2. 8% vs. 20. 6%,P<0. 001). Further intentional analysis showed that the incidence rate of delirium after surgery in the test group was still significantly lower than that in the control group(10. 5% vs. 19. 4%,P< 0. 05). The average hospitalization days of the test group was significantly less than that of the control group[(12. 15±3. 78) d vs.(16. 41±4. 69) d,P<0. 05],the score of satisfaction was higher than that of the control group(94. 44 ± 6. 29 vs. 85. 07 ± 5. 72,P< 0. 05). Conclusions The interdisciplinary intervention model based on HELP can reduce the incidence of postoperative delirium,shorten the average hospitalization days and improve patients’ satisfaction.

关 键 词：谵妄 老年人 多学科综合干预 手术 

分 类 号：R749.1[医药卫生—神经病学与精神病学]