骨科老年患者POCD原因分析及护理干预

Cause Analysis of Post-operative Cognitive Dysfunction in Elderly Orthopedic Patients and the Nursing Intervention

目的分析骨科老年患者手术后认知功能障碍（PoCD）产生的原因及护理干预的效果。方法回顾性分析我院骨科80例手术后发生认知功能障碍患者的临床资料和发病原因，总结护理干预的效果。结果引起老年患者POCD的原因有麻醉因素、心理异常和作息时间紊乱，其中有58例是麻醉因素所导致，占72．5％，与其他原因相比差异有统计学意义（P〈0．05）。经过护理干预后，18例患者在3d内恢复，占22．5％；48例患者在3～7d内恢复，占60．0％；另有14例患者在7～15d内恢复，占17．5％。结论麻醉因素、心理异常和作息时间紊乱是引起骨科老年患者POCD的主要原因，有效护理干预可促进患者认知功能障碍的恢复，在临床护理工作中具有可行性，值得推广应用。

Objective To analyze the causes of post-operative cognitive dysfunction （POCD） in elderly orthope dic patients and the effect of nursing intervention. Method With a retrospective analysis method, the clinical data and the causes of POCD of 80 cases of elderly orthopedic patients in our hospital were observed and the effect of nursing intervention was summarized. Results The causes of POCD in elderly patients were anesthe- sia, psychological abnormality and disorders of daily schedule. 58 cases were caused by anesthesia, accounting for 72.5% and compared with the other factors, the difference was statistically significant （P 〈 0.05 ）. After nursing intervention, 18 cases of patients recovered within three days, accounting for 22.5%; 48 cases of pa- tients recovered within three to seven days, accounting for 60.0% ; the rest 14 cases of patients recovered with in 7 to 15 days, accounting for 17.5%. Conclusion The main causes of POCD in elderly orthopedic patients are anesthesia, psychological abnormality and disorders of daily schedule. The effective nursing intervention can promote the recovery of cognitive dysfunction in patients; it is feasible in clinical nursing work and should be widely applied.