ICU老年患者发生术后急性谵妄的观察及护理

Observation and Nursing Care of Elderly Patients with Postoperative Acute Delirium in ICU

目的了解ICU的老年患者发生术后急性谵妄的情况及临床表现,以便采取相应的护理对策,改善病情.促进术后恢复。方法收集2005年12月至2007年12月术后入住我院ICU的312例老年患者,其中并发急性谵妄75例,对其临床资料进行分析。结果随着年龄的增长,术后发生急性谵妄的比例也增高。85岁以上的高龄患者术后急性谵妄的发生率明显高于其他年龄组。患有器质性脑病的患者发生术后急性谵妄的比例远远高于患有其他基础疾病的患者,采用全身麻醉方式的患者发生急性谵妄的比例高于采用其他麻醉方式的患者。结论应该充分认识老年患者术后急性谵妄的风险及临床表现,采取积极的护理措施,以减轻症状,促进其康复。

Objective To investigate the situation and clinical manifestations of postoperative acute delirium of elderly patients in ICU and take corresponding nursing countermeasures to improve their recovery. Methods Clinical data of 75 cases with postoperative acute delirium among 312 elderly patients hopitalized in our hospital from December,2005 to December,2007 were collected and analyzed. Results The occurrence rate of postoperative acute delirium increases with the age growing. The occurrence rate of postoperative acute delirium in patients over the age of 85 was significantly higher than those in groups of other age, patients with organic encephalopathy higher than those complicated with other underlying diseases, and patients with general anesthesia higher than those with other anestheia methods. Conclusion Risk and clinical manifestation of postoperative acute delirium in elderly patients should be fully realized and active nursing interventions should be taken to alleviate syptoms and improve recovery of patients.