晚期肿瘤患者谵妄症状的观察和处理

Management of delirium in patients with advanced cancer

目的探讨晚期肿瘤患者谵妄症状的护理效果。方法选取2012年12月至2014年12月成都市新都区中医医院诊治的186例晚期肿瘤患者,按照随机数字表法随机分为两组,对照组和观察组,每组93例。对照组患者实施常规护理,观察组患者实施针对性护理干预。比较两组患者的谵妄情况,分析谵妄的影响因素。结果谵妄与年龄、电解质紊乱、颅内转移灶、睡眠障碍关系密切(P<0.05)。谵妄与性别、3个月内手术、低血氧症、低蛋白血症、使用强效镇静剂、贫血、单次住院超过2周、肝肾功能不全无关(P>0.05)。观察组患者谵妄发生率低于对照组,护理依从性、护理满意度高于对照组(P<0.05)。结论有效的护理干预可降低晚期肿瘤患者谵妄的发生风险,年龄、电解质紊乱、颅内转移灶和睡眠障碍均为谵妄的影响因素。

Objective To observe symptoms of delirium and examine effect of nursing care in patients with terminal cancer. Methods One hundred and eighty-six patients with advanced cancer were selected in Xindu District Traditional Chinese Medicine Hospital from December 2012 to December 2014,who were divided into two groups by random digital table method. Ninety-three patients received routine nursing in the control group and 93 patients received nursing intervention in the observation group. Incidence and symptoms of delirium were compared between the two groups. Factors which influence delirium were analyzed. Results Delirium was closely associated with age,electrolyte disorders,intracranial metastases and sleep disorders（ P〈0. 05）. Relationship between delirium and gender,operation within 3 months,low blood oxygen,low serum albumin,use of powerful sedative,anemia,single hospitalization time more than 2weeks,and liver and kidney dysfunction was not significant（ P〉0. 05）. Incidence of delirium in the observation group was lower than that in the control group（ P〈0. 05）. Accordance to nursing care and satisfaction with nursing care in the observation group were higher than those in the control group（ P〈0. 05）. Conclusion Effective nursing intervention can reduce risk of delirium in patients with advanced cancer. Age,electrolyte disorders,intracranial metastases and sleep disorders are risk factors of delirium.