综合性护理干预对老年腹部手术患者全麻术后认知功能和并发症的影响.docVIP

综合性护理干预对老年腹部手术患者全麻术后认知功能和并发症的影响 　　[摘要] 目的 探讨综合性护理干预对老年腹部手术患者全麻术后认知功能和并发症的影响。方法 选择老年腹部手术患者72例，随机分为护理干预组和常规护理组。两组均在气管插管全身麻醉下行手术治疗。常规护理组予以围手术期常规护理，护理干预组予以综合性护理干预。 结果 术后1 d，两组患者MMSE和HDS评分均明显下降（P0.05），而常规护理组患者MMSE和HDS评分仍低于术前水平（P0.05）；同时护理干预组患者术后并发症的总发生率5.56%，明显低于常规护理组的22.22%（χ2 =4.18，P0.05）。 结论 综合性护理干预对老年腹部手术患者全麻术后认识功能下降具有一定的改善作用，能减轻术后认知功能下降，并能减少术后并发症发生率。 　　[关键词] 胃肠道手术；综合性护理；胃肠蠕动功能；并发症 　　[中图分类号] R459.3 [文献标识码] B [文章编号] 1673-9701（2013）36-0095-03 　　Influence of comprehensive nursing intervention on cognitive function and complication after general anesthesia of patients treated with elder abdominal operation 　　CHEN Zhensu 　　Surgical Department， the First Hospital of Wenling in Zhejiang Province， Wenling 317500，China 　　[Abstract] Objective To discuss influence of comprehensive nursing intervention on cognitive function and complication after general anesthesia of patients treated with elder abdominal operation. Methods Seventy-two cases of patients who were treated with elder abdominal operation by Department of General Surgery， were selected and divided into nursing intervention group and routine nursing group at random. The patients in two groups were operated in the treatment of general anesthesia by trachea cannula. The patients in routine nursing group were given routine nursing in perioperative period， while the patients in nursing intervention were additionally given comprehensive nursing intervention. Results The MMSE and HDS scores of patients in two groups obviously were declined after one day upon the operation（t=2.16， 2.35， 2.20， 2.29， P0.05）， while the MMSE and HDS scores of patients in routine nursing group were still lower than that before the operation（t=2.19，2.14， P 　　[Key words] Gastrointestinal operation； Comprehensive nursing； Gastrointestinal peristaltic function； Complication 　　术后认知功能障碍是一种较常见的中枢神经系统的并发症，好发于老年患者全麻术后。近年来随着人口的老龄化，老年患者进行手术的病例增多，从而增加术后认知功能障碍的发生率，导致患者遵医依从性下降，这不但影响患者术后的早日康复，而且还增加了术后并发症的发生率，需积极干预处理[1，2]。近年来研究发现综合性护理干预对老年腹部手术患者全麻术后