ABCDE集束化护理对心脏瓣膜置换术后患者谵妄和心功能的干预效果  

Effect of ABCDE bundles of care on the intervention of postoperative delirium and cardiac function in patients with heart valve replacement

作　　者：王娟[1] 肖兴米 彭林敏[1] 付仙兰 柳建 WANG Juan;XIAO Xingmi;PENG Linmin;FU Xianlan;LIU Jian(The Second Affiliated Hospital of Nanchang University,Nanchang 330000,China)

机构地区：[1]南昌大学第二附属医院心脏大血管外科,江西省南昌市330000

出　　处：《护理实践与研究》2024年第2期209-213,共5页Nursing Practice and Research

基　　金：江西省卫生健康委科技计划项目(编号:20204284)。

摘　　要：目的观察分析ABCDE集束化护理措施对心脏瓣膜置换术患者术后谵妄和心功能的干预效果。方法选择医院2022年1—6月收治的心脏瓣膜置换术患者120例,按照组间基本特征具有可比性的原则将患者分成对照组与观察组,各60例。对照组接受常规护理,观察组接受ABCDE集束化护理。比较两组患者谵妄发生率、谵妄持续时间、机械通气时间、住院时间、心功能[左心室射血分数(LVEF)、左心室舒张末期内径(LVDD)、左心室收缩末期内径(LVSD)和舒张期室间隔厚度(IVST)]与生活质量[生活质量评估表(QOL)评分]。结果护理干预后观察组患者术后谵妄发生率低于对照组,差异有统计学意义(P<0.05)。观察组患者谵妄持续时间、机械通气时间及住院时间短于对照组,差异有统计学意义(P<0.05)。护理干预后,观察组患者LVEF值,QOL量表中躯体功能、自理能力、社会关系、心理状态评分高于对照组,而IVST、LVDD及LVSD值低于对照组,差异有统计学意义(P<0.05)。结论心脏瓣膜置换术患者行ABCDE集束化护理能降低术后谵妄发生率,缩短康复时间,并可改善心功能,提升生活质量。Objective To observe and analyse the intervention effect of ABCDE bundles of care on postoperative delirium and cardiac function in heart valve replacement patients.Methods 120 cases of heart valve replacement patients admitted to the hospital from January to June 2022 were selected,they were divided into a control group and an observation group of 60 cases each according to the principle of comparability of basic characteristics between groups.The control group received conventional nursing care,and the observation group received ABCDE bundles of care.The incidence of delirium,duration of delirium,duration of mechanical ventilation,length of hospital stay,cardiac function[left ventricular ejection fraction(LVEF),left ventricular end-diastolic internal diameter(LVDD),left ventricular end-systolic internal diameter(LVSD),and diastolic interventricular septal thickness(IVST)]and quality of life[quality of life scale(QOL)score]were compared between the two groups.Results After the intervention,the incidence of postoperative delirium in patients of the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).The duration of delirium,mechanical ventilation time and hospitalisation time of patients of the observation group were less than those in the control group,the difference was statistically significant(P<0.05).After nursing intervention,the LVEF value,the scores of somatic function,self-care ability,social relationship and psychological state in QOL scale of the observation group were higher than the control group,and the IVST、LVDD and LVSD value were lower than the control group,and the difference was statistically significant(P<0.05).Conclusion ABCDE bundles of care for heart valve replacement patients can reduce the incidence of postoperative delirium,reduce the duration of delirium,mechanical ventilation time and hospital stay,and improve cardiac function and quality of life.

关 键 词：ABCDE集束化护理 心脏瓣膜置换术 谵妄 心功能 生活质量 

分 类 号：R473.6[医药卫生—护理学]