谵妄非药物预防护理对老年髋部手术患者的效果  

The effect of evidence-based practice of Non-drug preventive nursing care on incidence of delirium in elderly hip surgery patients during the awakening period

作　　者：李绍梅[1] 栾娟娟 孙亚楠 史永鹃 巩红岩[1] LI Shaomei;LUAN Juanjuan;SUN Yanan(The First Affiliated Hospital of Xinxiang Medical College,Xinxiang 453100,China)

机构地区：[1]新乡医学院第一附属医院麻醉科,新乡453100

出　　处：《国际精神病学杂志》2022年第3期545-548,共4页Journal Of International Psychiatry

基　　金：河南省医学科技攻关计划项目(编号:2018020365)。

摘　　要：目的探讨老年髋部手术苏醒期患者采用谵妄非药物预防护理的效果。方法本研究选择我院2019年1月~2020年10月80例老年髋部手术患者,数字表法随机分为对照组与观察组,对照组患者给予苏醒期常规护理,观察组采用谵妄非药物预防的循证护理。记录两组患者术中指标;采用意识模糊评估法(CAM)评估两组苏醒期谵妄发生情况,采用蒙特利尔认知评估量表(MoCA)评估离开苏醒室前认知功能,评估苏醒期riker镇静和躁动评分(SAS),对两组之间护理后的上述指标进行比较。结果两组手术时间,术中出血量等比较差异无统计学意义(P>0.05);观察组苏醒期谵妄发生率显著低于对照组,差异具有统计学意义(P<0.05);观察组MoCA评分显著高于对照组,SAS评分显著低于对照组,差异具有统计学意义(P<0.05)。结论老年髋部手术患者采用谵妄非药物预防的循证护理能够有效降低苏醒室内谵妄发生率,降低苏醒期躁动,提升患者认知功能。Objective To explore the effect of evidence-based practice of non-drug preventive nursing care for delirium during the awakening period of elderly hip surgery patients.Methods Eighty elderly hip surgery patients in our hospital from January 2019 to October 2020 were selected as the study subjects,and they were randomly divided into the control group and the observation group by the digital table method.Patients in the control group were given routine care during the recovery period,and the observation group was treated with evidence-based care for non-drug prevention of delirium.The intraoperative indexes of the two groups of patients were recorded;The confusion assessment method(CAM)to assess the occurrence of delirium in the two groups during the recovery period.The montreal cognitive assessment scale(MoCA)was used to assess cognitive function before leaving the recovery room.The riker sedation and restlessness score(SAS)during recovery were assessed.Results There was no significant difference in operation time and intraoperative blood loss between the two groups(P>0.05).The incidence of delirium in the recovery period of the observation group was significantly lower than that of the control group,and the difference was statistically significant(P<0.05).The MoCA score of the observation group was significantly higher than that of the control group,and the SAS score was significantly lower than that of the control group.The difference was statistically significant(P<0.05).Conclusion The evidence-based practice of non-drug preventive nursing care can effectively reduce the incidence of delirium in elderly hip surgery patients,reduce their restlessness during the recovery period,and improve their cognitive function of patients.

关 键 词：老年髋部手术 苏醒期 谵妄 非药物预防护理 循证实践 

分 类 号：R749[医药卫生—神经病学与精神病学]