外科老年患者术后认知功能障碍的观察及护理

Observation and nursing of postoperative cognitive dysfunction of elderly patients in surgery

目的观察外科老年患者术后认知功能障碍（POCD）的治疗护理效果。方法术后认知功能障碍（POCD）患者45例，据患者情况给予对症支持治疗，并予相应的综合护理，观察其治疗护理效果。结果所有患者术后恢复良好，均痊愈出院，精神症状消失时间4～13（8．6±2．5）d，住院时间（11．5±2．7）d，随访6个月～2年无复发。护理后，患者洛文斯顿认知功能测验（LOTCA）评分为（81．6±21．5）分高于护理前的（57．4±17．6）分，差异有统计学意义（P〈0．05）。结论对外科老年患者应提前做好围术期预防性护理，同时对已发生术后认知功能障碍者应积极进行神经内科检查和治疗，促进患者认知功能早日恢复。

Objective To observe the treatment and nursing effect of postoperative cognitive dysfunction （POCD） of elderly patients in surgery. Methods 45 cases patients with POCD, gave symptomatic and supportive treatment according to the patient＇s condition, and gave accordingly integrated nuursing. Observe the treatment and nursing effect of patients. Results All patients recovered well and discharged, psychiatric symptoms disappear time 4 -13 （8.6± 2.5 ）d, hospitalization time （ 11.5 ± 2.7 ） d, followed up for 6 months to 2 years without recurrence. After treatment, patients Loewenstein cognitive function tests （LOTCA） score （81.6 ~ 21.5 ） was higher than before treatment （57.4 ~ 17.6）, the difference was statistically signifi- cant （P 〈 0.05）. Conclusion Olderly patients in surgery should be given preventive care in advance of perioperative, while given actively neurology examination and treatment to patients with POCD, and promote the cognitive function resumption early.