普外科术后患者谵妄原因研究及护理体会(附15例研究).doc

普外科术后患者谵妄原因研究及护理体会(附15例研究)【摘要】目的分析15例普外科患者术后出现谵妄的原因,总结护理体会。方法2008年1月---2009年11月对我科收治的15名患者(42―78岁)外科手术后出现谵妄进行分析,其中男10例,女5例。结肠造瘘术后5例,胃大部切除术后4例,阑尾穿孔全腹膜炎2例,部分小肠切除术后2例,胰十二指肠切除术后1例,开腹胆囊切除术后1例。结果谵妄出现时间最早麻醉清醒后8小时,最晚术后72小时,平均术后48小时,谵妄持续时间最短6小时,最长48小时,平均16小时。部分患者与心里因素、应激反应、低氧血症、疼痛及药物有关。结论谵妄在手术后尤其老年病人中发病率是很高的,应值得重视,要重视谵妄的临床特征,早期发现,及时给予全面、合理、安全的护理,配合药物治疗,可明显改善预后,对促进恢复有重要意义。 【关键词】术后谵妄原因分析护理体会 中国图分类号:R7473.6 文献标识码:A 文章编号:1005-0515(2010)08-040-02 After Pu surgical department technique, patient delirium reason analysis and nursing experience(Attaches 15 example analyses) ZHENGYu Mei (Sichuan Ziyang first People’s Hospital Pu surgical department,Sichuan Ziyang 641300) 【Abstract】ObjectiveAnalysis of 15 cases of general surgery patients with postoperative delirium reasons, summed up Nursing. MethodsJanuary 2008 --- November 2009 to my subjects treated in 15 patients (42-78 years) delirium after surgery for analysis, of which 10 males and 5 females. Colostomy after 5 cases, 4 cases with partial gastrectomy, two cases of appendiceal perforation peritonitis-wide, part of the small bowel resection in 2 cases, after pancreatoduodenectomy in 1 case, after an open cholecystectomy cases. ResultsDelirium occurred earliest, after eight hours awake anesthesia, at the latest after 72 hours, an average after 48 hours, delirium duration of the shortest 6 hours, up to 48 hours, an average of 16 hours. Some patients with heart factors, stress response, hypoxemia, pain and drugs. ConclusionThe post-operative delirium in elderly patients in particular, the incidence rate is very high and should be worthy of attention, should pay attention to the clinical features of delirium, early detection, timely to give a comprehensive, reasonable, safe care, with medication, can significantly improve the prognosis, great significance in promoting recovery. 【Key words】 postoperative delirium cause analysis Nursing Experience 谵妄是一组表现为急性、一过性、广泛性的认知障碍,又以意识障碍为主要特征。因急性起病、病程短暂、病变发展迅速,故又称为“急