第五章 36例老年髋部骨折患者术后谵妄护理.docVIP

36例老年髋部骨折患者术后谵妄护理 【摘要】目的 研究基层医院老年髋部骨折病人术后谵妄（POD）护理措施。方法 对134例老年髋部骨折术后病人进行护理谵妄筛查量表（Nu-DESC）评估，并对其中初次发现谵妄的36例病人做老年谵妄测验表（CAM-CR）评估，对该36例病人进行术后一般护理和POD综合干预护理，并记录其平均住院时间和谵妄持续时间。结果 用Nu-DESC评估POD发生与CAM-CR评估符合率为100%；POD病人的平均住院时间（18.8±3.2天）比与同期无POD发生的病人（16.5±2.9天）长， P0.05；POD病人经综合干预护理后的谵妄平均持续时间为2.8±1.1天。结论Nu-DESC简便准确，适用于基层医院护士用作POD评估；综合干预护理有利于缩短病人的住院时间，提高术后的康复质量和生活质量。 【关键词】老年；髋部骨折；术后谵妄；护理  Treatment of postoperative delirium care in 36 elderly patients with hip fracture The People`s Hospital Of CengXi City,dongni Wu,yeli Deng,yuxian Pan 【Abstract】Objective: To study the nursing measures of postoperative delirium (POD) in senile patients with hip fracture . Method:134 cases of elderly hip fracture patients postoperative is evaluated by Nu-DESC (Nursing Delirium Screening Scale), and 36 patients with delirium were evaluated for the CAM-CR(燙onfusion燗ssessment燤ethod) as well, ev The 36 patients were treated with general nursing and POD comprehensive nursing intervention, and the average length of stay and duration of delirium were recorded. Results: the coincidence rate between POD and CAM-CR was 100%, and the average length of hospital stay (18.8?.2i days) of POD patients was longer than that of patients without POD (16.5?.9o days), and P0.05; The average duration of delirium in patients with POD after comprehensive intervention was 2.8?1.1 days. Conclusion: Nu-DESC is simple and accurate, and it is suitable for primary hospital nurses as POD assessment. Comprehensive intervention nursing is helpful to shorten the hospital stay and improve the quality of rehabilitation and quality of life. 【Keywords】elderly patients, hip fracture, postoperative delirium, care 谵妄是急性认知功能改变，表现为随时间波动的意识改变和注意力不集中。术后谵妄（Postoperative?Delirium，POD）是指患者在经外科手术后出现的谵妄，其发生具有明显的时间特点，主要发生在术后24～72h[1]。随着人口老龄化进程的不断加速，老年髋部骨折已经成为老年人残疾和死亡的重要原因之一，其造成的家庭和医疗负担均较高，对患者身心健康与生活质量的危害日益增大[2]。为此,我院对 36例65岁以上的髋部骨折病人进行术后谵妄的综合干预,取得较好的效果，现报道如下。 1. 资料与方法 1.1 临床资料 选择2015年6月～2016年10月在我院骨科住院的老年髋部骨折术后发生谵妄的36例病人作为研究对象，入选标准：①年龄≥65岁；