早期路径化护理干预对胸部外科老年患者全身麻醉术后认知功能障碍的研究  

A study on Early Pathway Nursing Intervention for Cognitive Impairment in Elderly Patients Undergoing General Anesthesia in Thoracic Surgery

作　　者：王世杰[1] 贾佳 王淑蒨 WANG Shijie;JIA Jia;WANG Shuqian(First Affiliated Hospital of Xiamen University Department of Thoracic Surgery,Xiamen 361000,china)

机构地区：[1]厦门大学附属第一医院胸外一科,福建厦门361000

出　　处：《中华灾害救援医学》2024年第4期468-470,共3页Chinese Journal of Disaster Medicine

基　　金：2019医疗卫生科技计划项目(2019S2911)。

摘　　要：目的探讨对接受全身麻醉的胸部外科老年患者实施早期路径化护理对术后认知功能障碍发生情况的影响。方法将厦门大学附属第一医院胸外科于2022年12月至2023年12月期间收治的144例老年手术患者纳入研究,患者术中均接受胸腔镜下全麻手术。将患者随机分组后实施不同的临床护理,一共分为两组,各组均72例。对照组实施常规护理,观察组实施早期路径化护理干预。测量并比较两组术前、术后1d认知功能评分,评估并统计术后认知障碍发生率,并调查患者满意度。结果术前测量并分析两组患者认知功能量表评分结果,显示组间差异不明显(P>0.05);术后1d再次测量,比较两组术后认知功能量表评分结果,对照组明显低于观察组(P<0.05)。观察组术后自主呼吸、睁眼、意识恢复时间明显短于观察组(P<0.05)。参照两组认知功能评分进行认知功能障碍判定,比较两组总发生率,对照组为12.50%,明显高于观察组2.78%(P<0.05)。入组患者均接受满意度调查,统计并比较两组临床护理方案实施满意度调查结果,观察组平均得分明显高于对照组(P<0.05)。结论针对接受全身麻醉的胸部外科老年患者,实施早期路径化护理干预可减少术后认知功能障碍发生率,提高患者满意度。Objective To explore the impact of early pathway nursing on postoperative cognitive impairment in elderly patients undergoing general anesthesia in thoracic surgery.Methods 144 elderly surgical patients admitted to the thoracic surgery department of our hospital from December 2022 to December 2023 were included in the study.All enrolled patients received surgical treatment and general anesthesia during the surgery.Patients are randomly divided into two groups and received different clinical care.Each group included 72 patients.The control group received routine care,while the observation group received early pathway nursing intervention.We measured and compared the cognitive function scores of two groups before and one day after surgery,evaluated and calculated the incidence of postoperative cognitive impairment,and investigated patient satisfaction with clinical nursing.Result Before surgery,the cognitive function scale scores of two groups of patients were measured and analyzed,and the test showed that there was no significant difference between the two groups(P>0.05);One day after surgery,the postoperative cognitive function scale scores were measured again and compared between the two groups.Those of the control group was significantly lower than those of the observation group(P<0.05).The postoperative spontaneous breathing,eye opening,and consciousness recovery time in the observation group were significantly shorter than those in the observation group(P<0.05).Referring to the cognitive function scores of two groups for cognitive dysfunction assessment,the total incidence rate of the control group was 12.50%,which was significantly higher than the observation group’s 2.78%(P<0.05).All enrolled patients underwent a satisfaction survey,and the results of the satisfaction survey on the implementation of clinical nursing plans were compared between the two groups.The average score of the observation group was significantly higher than that of the control group(P<0.05).Conclusion Early pathway nursing intervent

关 键 词：胸部外科 老年患者 全身麻醉 术后认知功能障碍 护理 早期路径化护理干预 

分 类 号：R473.6[医药卫生—护理学]