多模式镇痛联合心理干预对老年股骨术后谵妄的影响  

Effect of Multi-Mode Analgesia Combined with Psychological Intervention on Postoperative Delirium in Aged Patients After Femoral Surgery

作　　者：唐晓辉 TANG Xiaohui(Department of Anesthesiology,Jishou People's Hospital,Jishou 416000,Hunan China)

机构地区：[1]吉首市人民医院麻醉科,湖南吉首416000

出　　处：《吉首大学学报（自然科学版）》2024年第2期84-88,共5页Journal of Jishou University(Natural Sciences Edition)

摘　　要：为了探究多模式镇痛联合个性化心理干预对老年股骨术后谵妄的治疗效果,将2021年1月至2023年8月在湖南省吉首市人民医院骨科收治的80例老年股骨骨折患者随机分为观察组(40例)和对照组(40例).观察组采用多模式镇痛联合个性化心理干预措施,对照组采用常规术后镇痛措施,观察并分析两组患者的血流动力学指标、血气指标、疼痛程度、睡眠质量及谵妄发生情况.结果表明,与对照组患者相比,观察组患者麻醉前、手术开始、手术结束时的心率及平均动脉压较低,静息及活动疼痛程度评分较低.术后第1,3,7天失眠情况评分较低,术后出现谵妄的概率较低,术后第1天的血气指标PaO_(2),SaO_(2)和OI值较高,两组之间上述指标差异均具有统计学意义(P<0.05).多模式镇痛联合个性化心理干预方法在维持患者呼吸循环稳定、提高患者术后睡眠质量、缓解患者术后疼痛和焦虑、促进患者术后快速康复等方面起积极作用,降低了术后谵妄的发生率,是快速康复外科的重要措施之一.To explore the effect of multi-mode analgesia combined with personalized psychological intervention on postoperative delirium in aged patients after femoral surgery,80 aged patients with femoral fracture admitted to the Department of Orthopedics of Jishou People's Hospital of Hunan Province from January 2021 to August 2023 were randomly divided into observation group(40 cases)and control group(40 cases).The observation group was given multi-mode analgesia combined with personalized psychological intervention,and the control group was given routine postoperative analgesia.The hemodynamic index at different time after operation,blood gas index on the first day after operation,sleep quality,relief of pain and anxiety,and delirium occurrence in the two groups of patients were observed and analyzed.The results showed that compared with the control group,the patients in the observation group had lower heart rate,lower mean arterial pressure,lower resting and activity pain scores before anesthesia,at the beginning and the end of surgery;on the 1st,3rd and 7th day after surgery,the score of insomnia and the probability of postoperative delirium were lower;the blood gas indexes PaO_(2),SaO_(2) and OI were higher on the 1st day after surgery;and the differences in the above indexes between the two groups were statistically significant(P<0.05).It can be concluded that the method of multi-mode analgesia combined with individual psychological intervention can play an active role in maintaining the stability of respiration and circulation,improving the postoperative sleep quality,relieving the postoperative pain and anxiety,and promoting the postoperative rapid rehabilitation of the patients,and it can reduce the incidence of postoperative delirium and improve the cognitive function of aged patients,which is an important part of rapid rehabilitation surgery.

关 键 词：多模式镇痛 老年股骨骨折 术后谵妄 个性化心理干预 

分 类 号：R473.6[医药卫生—护理学]