术后早期渐进式进食对减少老年髋关节置换患者谵妄的影响  

Effect of early gradual diet on reducing delirium in elderly patients after hip arthroplasty

作　　者：梁晓玲 杨叶香[1] 谢秋月 罗培培[2] 黄师菊[3] 翟春杰 李新欢 吴美娥[1] 黄甜[1] 邓梦迪 何晓兰[4] Liang Xiaoling;Yang Yexiang;Xie Qiuyue;Luo Peipei;Huang Shiju;Zhai Chunjie;Li Xinhuan;Wu Mei′e;Huang Tian;Deng Mengdi;He Xiaolan(Joint Surgery/Orthopedic Trauma Department,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China;Department of Nursing,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China;Department of Surgery,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China;Department of Gastrointestinal Surgery,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院关节外科创伤骨科,广州510630 [2]中山大学附属第三医院护理部,广州510630 [3]中山大学附属第三医院外科,广州510630 [4]中山大学附属第三医院胃肠外科,广州510630

出　　处：《中国实用护理杂志》2021年第14期1047-1050,共4页Chinese Journal of Practical Nursing

基　　金：广东省医学科研基金(A2018398)。

摘　　要：目的探讨术后早期渐进式进食对减少老年髋关节置换患者谵妄的影响。方法选择2018年1月至2020年1月于中山大学附属第三医院进行治疗的≥65岁髋关节置换患者74例为研究对象,按照随机数字表法分为试验组和对照组各37例。试验组在常规术后护理基础上早期渐进式进食干预,对照组在常规术后护理基础上常规术后进食。利用术后谵妄发生率、匹兹堡睡眠质量指数(PSQI)、患者满意率、平均住院日、平均住院费用来评价术后早期渐进式进食对减少老年髋关节置换患者谵妄的影响。结果试验组谵妄发生率为2.70%(1/37),对照组为16.22%(6/37),2组比较差异有统计学意义(χ2值为3.945,P<0.05);试验组住院天数(10.68±5.13)d,对照组为(13.62±7.19)d,2组比较差异有统计学意义(t值为2.877,P<0.01);试验组入睡困难发生率、满意率分别为8.11%(3/37)、94.59%(35/37),对照组分别为29.73%(11/37)、78.38%(29/37),2组比较差异有统计学意义(χ2值为5.638、4.163,P<0.05)。结论术后早期渐进式进食可减少老年髋关节置换患者谵妄的发生率,缩短平均住院时间,降低入睡困难发生率,提高患者满意率,有助于患者更安全舒适地渡过围手术期。Objective To investigate the effect of early gradual diet on reducing delirium in elderly patients with hip arthroplasty.Methods From January 2018 to January 2020,74 cases of hip arthroplasty patients aged over 65 years old who were treated in the Third Affiliated Hospital of Sun Yat-sen University were selected as the observation objects.They were randomly divided into experimental group and control group with 37 cases in each group.The experimental group was given early gradual diet on the basis of routine postoperative care,while the control group was given routine postoperative diet on the basis of routine postoperative care.The incidence of postoperative delirium,Pittsburgh Sleep Quality Index(PSQI),patient satisfaction rate,average hospitalization days and average hospitalization expenses were used to evaluate the effect of early gradual diet on reducing delirium in elderly patients with hip arthroplasty.Results The incidence of delirium in the experimental group was 2.70%(1/37)and 16.22%(6/37)in the control group,the difference was statistically significant(χ2 value was 3.945,P<0.05);the hospitalization days of the experimental group were(10.68±5.13)d,(13.62±7.19)d in the control group.The difference of hospitalization days was statistically significant(t value was 2.877,P<0.01).The incidence of difficulty in falling asleep and the satisfaction rate of the experimental group were 8.11%(3/37)and 94.59%(35/37)respectively,and those in the control group were 29.73%(11/37)and 78.38%(29/37)respectively,and the differences were statistically significant(χ2 value was 5.638,4.163,P<0.05).Conclusions Early gradual diet after operation can reduce the incidence of delirium in elderly patients with hip arthroplasty,shorten the average hospitalization days,reduce the incidence of difficulty in falling asleep,improve patients'satisfaction,and help patients to pass through the perioperative period more safely and comfortably.

关 键 词：入睡困难 老年髋关节置换 患者满意率 谵妄 平均住院费用 术后早期 渐进式 围手术期 

分 类 号：R473.6[医药卫生—护理学]