家属赋能模式在Stanford A型主动脉夹层患者术后谵妄管理中的应用  

Application of family empowerment model in postoperative delirium management of patients with Stanford type A aortic dissection

作　　者：赵俊[1] 张山 赵洪霞[1] 胡晓鸿[3] 秦彦荣[3] 吴瑛[2] Zhao Jun;Zhang Shan;Zhao Hongxia;Hu Xiaohong;Qin Yanrong;Wu Ying(Aortic Surgery Center Ward 1,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China;School of Nursing,Capital Medical University,Beijing 100069,China;Nursing Department,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院主动脉外科中心一区,北京100029 [2]首都医科大学护理学院,北京100069 [3]首都医科大学附属北京安贞医院护理部,北京100029

出　　处：《中华现代护理杂志》2023年第21期2886-2891,共6页Chinese Journal of Modern Nursing

摘　　要：目的探讨家属赋能模式在Stanford A型主动脉夹层患者术后谵妄管理中的应用效果。方法采用便利抽样法,选取北京安贞医院2019年2—12月接受外科手术的316例Stanford A型主动脉夹层患者作为研究对象,根据患者是否接受基于家属赋能模式的术后谵妄管理分为观察组(n=204)与对照组(n=112)。应用Richmond躁动-镇静评分量表(RASS)、重症监护室患者意识模糊评估法(CAM-ICU)评估患者术后谵妄情况,比较两组患者谵妄发生率、ICU住院时间、总住院时间及ICU获得性感染发生率,记录并比较两组发生谵妄患者的谵妄持续时间。结果对照组谵妄发生率为16.96%(19/112),谵妄持续时间为3(3,4)d;观察组谵妄发生率为9.31%(19/204),谵妄持续时间为3(2,3)d;两组比较差异有统计学意义(P<0.05)。观察组ICU住院时间为(3.38±1.12)d,对照组为(3.74±1.44)d,两组患者ICU住院时间比较,差异均有统计学意义(P<0.05)。两组患者总住院时间、ICU获得性感染发生率比较,差异无统计学意义(P>0.05)。结论基于家属赋能参与的术后谵妄管理能降低Stanford A型主动脉夹层患者术后谵妄的发生率,降低患者术后谵妄持续时间,家属赋能模式可以减少患者ICU住院时间,且未增加ICU获得性感染发生率。Objective To analyze the application effect of family empowerment model on postoperative delirium management in Stanford type A aortic dissection patients.Methods Using the convenient sampling method,a total of 316 patients with Stanford type A aortic dissection who underwent surgery in Beijing Anzhen Hospital from February to December 2019 were selected as the research objects.The research objects were divided into the observation group(n=204)and the control group(n=112)based on whether they have received postoperative delirium management based on family empowerment mode.The Richmond Agitation and Sedation Scale(RASS)and Confusion Assessment Method for the Intensive Care Unit(CAM-ICU)were used to evaluate postoperative delirium in patients.The incidence of delirium,length of ICU stay,the total length of hospital stay and incidence of ICU acquired infection were compared between the two groups.The duration of delirium was recorded and compared between the two groups.Results The incidence of delirium in the control group was 16.96%(19/112),and the duration of delirium was 3(3,4)d.The incidence of delirium in the observation group was 9.31%(19/204),and the duration of delirium was 3(2,3)d.The differences between the two groups were statistically significant(P<0.05).The length of ICU stay in the observation group was(3.38±1.12)d,while that in the control group was(3.74±1.44)d.There was statistically significant difference in the length of ICU stay between the two groups(P<0.05).There was no statistically significant difference in the total hospital stay and incidence of ICU acquired infection between the two groups(P>0.05).Conclusions Family empowerment based postoperative delirium management can reduce the incidence and duration of postoperative delirium in Stanford type A aortic dissection patients.Family empowerment mode can reduce the length of ICU hospitalization for patients without increasing the incidence of ICU acquired infections.

关 键 词：主动脉夹层 重症监护室 术后谵妄 家属赋能 

分 类 号：R473.6[医药卫生—护理学]