老年髋部骨折患者围手术期谵妄管理方案的实施及效果评价

发布时间：2019-05-20 06:43

【摘要】：目的提高老年髋部骨折患者术后谵妄的护理质量。方法建立多学科合作团队,参照2014美国老年医学会提供的防治老年患者术后谵妄临床指南,通过术前氧疗同期配合呼吸功能训练、术中灌注平衡与体温控制及限制性输血、术后多模式镇痛与综合睡眠管理,实施专业化、系统化围手术期谵妄管理方案,降低老年髋部骨折患者术后谵妄发生率。结果实验组和对照组术后谵妄发生率分别为16.36%(9/55)和30.91%(17/55),谵妄持续时间分别为(3.37±1.21)d和(4.53±1.87)d,术后低氧血症发生率分别为9.09%(5/55)和14.55%(8/55),同时术后每日总睡眠时间分别为(5.18±0.53)h和(3.56±0.69)h。结论围手术期谵妄管理方案融入了多项护理应对策略及质量持续改进项目,缩短了老年髋部骨折患者术后首次下床时间和平均住院日,降低了术后谵妄发生率。
[Abstract]:Objective to improve the nursing quality of postoperative delirium in elderly patients with hip fracture. Methods to establish a multi-disciplinary cooperative team, referring to the clinical guidelines for the prevention and treatment of postoperative delirium in elderly patients provided by the American Association of Geriatrics in 2014, through preoperative oxygen therapy combined with respiratory function training, intraoperative perfusion balance, body temperature control and restricted blood transfusion. After operation, multi-mode analgesia and comprehensive sleep management, professional and systematic management of delirium during perioperative period were carried out to reduce the incidence of postoperative delirium in elderly patients with hip fracture. Results the incidence of postoperative delirium was 16.36% (9 鈮，

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