老年肝癌切除术患者术后发生谵妄的相关因素分析及医护对策

Related factors,treatment,and nursing countermeasures of delirium in elderly patients after liver resection

目的探讨老年肝癌切除术患者术后发生谵妄的影响因素,并对处理方法和护理对策进行总结。方法选择2010年1月至2014年7月间收治的189例老年肝癌切除术手术患者为研究对象,分析肝癌切除术患者的谵妄发生因素,并对护理要点进行总结。结果 189例肝癌切除术患者中,发生谵妄15例,发生率为7.9%,将患者按照年龄、低血氧饱和度(Sp O2)、疼痛程度及睡眠时间不同进行分组分析,不同组间患者的谵妄发生率差异有统计学意义(P<0.05)。年龄较高、低Sp O2、疼痛较严重的患者术后谵妄发生率较高,差异有统计学意义(P<0.05)。结论患者年龄、血氧浓度及术后疼痛均可导致谵妄的发生。因此,应针对相关原因及早进行护理干预,消除致病因素影响,以有效预防术后谵妄的发生。

Objective To discuss the related factors,treatment,and nursing countermeasures of delirium in elderly patients after liver resection. Methods Between January 2010 and July 2014,189 cases of elderly patients with hepatocellular carcinoma accepting resection operation in the First Affiliated Hospital of Chinese PLA General Hospital were enrolled in the study. The occurrence factors were analysed and the nursing points were summarized. Results Fifteen cases had delirium and the occurrence rate was7. 9%. Patients were divided into different groups based on age,low oxygen saturation（ Sp O2）,pain,and sleep time. The resulta showed that the delirium rate of patients in different groups were significantly different（ P〈0. 05）. Age,low Sp O2,pain and sleep time were included in the regression equation,and the result showed that age,low Sp O2 and pain were related to the delirium rate（ P〈0. 05）,which indicated the higher age,the probability of hypoxemia,and pain related to the higher the delirium rate. Conclusions There are many factors for postoperative delirium,including the patient＇s age,oxygen concentration,and postoperative pain. Therefore,the related early nursing intervention should be done to eliminate pathogenic factors and effectively prevent the occurrence of postoperative delirium.