早期分级活动护理干预对ICU全麻手术老年患者认知功能及谵妄发生的影响  

The effect of early graded activity nursing intervention on the cognitive function and the occurrence of delirium in elderly patients undergoing general anesthesia in ICU

作　　者：范真[1] FAN Zhen(Department of Critical Care Medicine,Houjie Hospital of Dongguan,Dongguan 523900,China)

机构地区：[1]东莞市厚街医院重症医学科,广东东莞523900

出　　处：《包头医学院学报》2021年第6期67-69,共3页Journal of Baotou Medical College

摘　　要：目的:探讨早期分级活动护理干预对ICU全麻手术老年患者认知功能及谵妄发生的影响。方法:选取2019年1月至2020年10月104例ICU全麻手术老年患者分为观察组和对照组。对照组采用常规护理,观察组采用早期分级活动护理干预。比较不同时间点两组患者谵妄发生率、谵妄严重程度;首次谵妄发生时间、谵妄持续时间及ICU住院时间;出ICU时两组患者认知功能评分,术后并发症发生情况。结果:进入ICU 36 h、48 h及出ICU时观察组患者谵妄发生率分别为3.85%、7.69%、9.62%,较对照组患者的23.08%、38.46%、42.31%均显著下降,严重程度均较观察组患者减轻(P<0.05);观察组患者谵妄持续时间、ICU住院时间较对照组患者显著缩短(P<0.05),两组患者首次谵妄发生时间无显著性差异(P>0.05);出ICU时观察组患者LOTCA量表中注意力和专注力、思维操作、视力运动组织时间、动作运动、空间知觉、视知觉、定向评分均显著高于对照组患者(P<0.05);观察组患者术后并发症发生率为7.69%,较对照组患者的23.08%显著降低(P<0.05)。结论:对于ICU全麻手术老年患者给予早期分级活动护理干预可降低术后谵妄的发生率,减轻谵妄的严重程度,缩短谵妄发生的持续时间,改善认知功能,减少并发症发生,保证患者的安全,值得推广。Objective:To explore and analyze the effect of early graded activity nursing intervention on the cognitive function and the occurrence of delirium in elderly patients undergoing general anesthesia in ICU. Methods:104 elderly patients undergoing general anesthesia in ICU from January 2019 to October 2020 were chosen and divided into the experimental group and the control group. The control group were given routine nursing care, while the experimental group were given early graded activity nursing intervention, with the incidence of delirium, the severity of delirium at different time points, the first occurrence of delirium, the duration of delirium, the length of ICU hospitalization, cognitive function scores when they left the ICU, and the occurrence of postoperative complications compared between the two groups. Results:The incidence of delirium in the experimental group was 3.85 %, 7.69 %, and 9.62 % respectively 36 h and 48 h after entering the ICU and the time leaving the ICU, significantly more decreased than those of the experimental group, which were 23.08 %, 8.46 % and 42.31 % respectively(P<0.05). The duration of delirium and ICU stay in the experimental group were significantly shorter than that of the control group(P<0.05). There was no significant difference in the first time delirium occurrence in both groups(P>0.05). The scores of attention and concentration, thinking operation, visual movement organization time, motor movement, spatial perception, visual perception, and orientation on the LOTCA scale in the experimental group out of ICU were significantly higher than those in the control group(P<0.05).The postoperative complication rate of the experimental group was 7.69 %, which was significantly lower than that of the control group( 23.08 %)(P<0.05). Conclusion:Early graded activity care should be given to elderly patients undergoing general anesthesia in ICU, which can reduce the incidence of postoperative delirium and the severity of delirium, shorten the duration of delirium, improve cognitiv

关 键 词：早期分级活动 护理干预 全麻 认知功能 谵妄 

分 类 号：R473.6[医药卫生—护理学]