系统护理干预在预防骨科老年患者术后认知功能障碍中的应用.docx

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系统护理干预在预防骨科老年患者术后认知功能障碍中的应用

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【摘要】目的：探讨系统护理干预在预防脊柱外科老年患者术后认知功能障碍（POCD）中的应用效果。方法：选取老年择期手术患者112例，随机分为对照组和干预组，对照组56例给予围术期常规护理，干预组56例给予系统护理干预。于手术前后采用简易精神状态量表（MMSE）定量评估POCD程度，采用韦氏智力量表（WMS）评估记忆商，统计两组术后POCD发生率、认知功能恢复时间和住院时间。结果：干预组术后3dMMSE和WMS评分均较术前下降（P＜0.05），且明显优于对照组（P＜0.05）。干预组术后POCD发生率低于对照组（P＜0.05），认知功能恢复和住院时间均短于对照组（P＜0.05）。结论：实施系统护理干预可预防脊柱外科老年患者术后认知功能障碍发生，促进康复。

【关键词】护理干预；骨科；老年患者；认知功能障碍

Applicationofsystematicnursinginterventioninpreventionofpostoperativecognitivedysfunctioninorthopedicelderlypatients

【Abstract】Objective:Toexploretheeffectofsystematicnursinginterventioninthepreventionofpostoperativecognitivedysfunction(POCD)inelderlypatientswithspinalsurgery.Methods:112elderlypatientsundergoingelectivesurgerywererandomlypidedintoacontrolgroupandaninterventiongroup.Thecontrolgroupreceived56casesofperioperativeroutinenursingandtheinterventiongroupreceived56systematicnursinginterventions.Beforeandaftertheoperation,asimplementalstatescale(MMSE)wasusedtoquantitativelyevaluatethedegreeofPOCD,andaWechslerIntelligenceScale(WMS)wasusedtoevaluatethememoryquotient.TheincidenceofpostoperativePOCD,therecoverytimeofcognitivefunctionandthelengthofhospitalizationwerecounted.Results:Thepostoperative3dMMSEandWMSscoresoftheinterventiongroupwerelowerthanthosebeforetheoperation(P0.05),andweresignificantlybetterthanthecontrolgroup(P0.05).TheincidenceofpostoperativePOCDintheinterventiongroupwaslowerthanthatinthecontrolgroup(P0.05),andtherecoveryofcognitivefunctionandhospitalstaywereshorterthanthatinthecontrolgroup(P0.05).Conclusion:Implementingsystematicnursinginterventioncanpreventpostoperativecognitivedysfunctioninelderlypatientswithspinalsurgeryandpromoterehabilitation.

[Keywords]nursingintervention;orthopedics;elderlypatients;cognitiv