摘要
目的探讨高龄老人髋部骨折围手术期谵妄的诊断、治疗、康复和疗效。方法总结分析高龄(75岁以上)髋部骨折204例的临床资料,分析患者年龄、并存疾病、伤前活动能力、创伤心理、水电平衡等因素对谵妄产生的影响。结果围手术期共发生谵妄96例,发生率47.06%,患者伤前日常生活指数X2=6.62,P〈0.05)、伤前并存疾病X2=32.74,P〈0.01)、水电酸碱平衡(好=35.22,P〈0.01)对患者谵妄发生有统计学意义。结论高龄髋部骨折围手术期极易引起谵妄,术前须做好身体综合评估,纠正并存疾病,术后必须配合良好的康复治疗和社会家庭支持,则能显著提高患者伤后生活质量。
Objective To explore the diagnose, the treatment, the rehabilitation and the curative effect of perioperative delirium in the elderly with hip fracture. Methods Review the clinical data of 204 patients ( over 75 years old) with hip fracture, analyzing the affect of factors as age, coexisting disease, activity before injury, psychol- ogy of trauma and water - electrolyte balance on delirium. Results Perioperative delirium occurred in 96 cases (47.6%). Patients before injury ADL index ( X2 = 6. 62 ,p 〈 0.05 ) , coexisting diseases ( X2 = 32. 74 ,p 〈 0. 01 ), water electrolyte and acid - base balance ( Z2 = 35.22 ,p 〈 0. 01 ) affect on patients' delirium with statistical signifi- cance. Conclusion For elderly patients with hip fracture the perioprative delirium is apt to occur, so comprehensive evaluation of surgical tolerance and correct other diseases before operation are very important; with the support of so- cial and family and good rehabilitation, the quality of life after injury will be enhanced remarkably.
出处
《现代医院》
2012年第12期24-26,共3页
Modern Hospitals
关键词
髋部骨折
高龄
75岁以上
骨科手术
围手术期谵妄
Hip fracture, Elderly, Over 75 years, Orthopedic surgery, Perioperative delirium