集束化管理对心脏术后患者谵妄发生率的影响

Effect of cluster Management on the Incidence of Delirium in Patient After Cardiac Surgery

目的探讨集束化管理对心脏术后患者谵妄发生率的影响。方法选取心血管外科2014年5月~2015年12月行瓣膜置换及冠状动脉搭桥术的320例患者作为研究对象,按随机数字表法分为对照组和观察组。对照组给予常规护理,观察组在此基础上给予集束化管理,包括人员培训、评估量表的使用及评估的频次、时间、诱发谵妄药物的控制及早期抗焦虑药物的使用、护理措施等方面。比较两组患者术后谵妄发生率和发生谵妄者恢复时间。结果观察组谵妄发生率仅为5%,而对照组谵妄发生率为25%,差异有统计学意义(P<0.05);谵妄持续时间相比,观察组8例谵妄患者中持续时间短,仅有1例患者于出院后3个月症状消失。结论集束化管理措施采用全面系统的预防和护理措施,且针对性强,对心脏术后谵妄患者能早预防、早发现、早处理,减少不良及意外事件的发生。

Objective Explore the effect of cluster management measures on the incidence of delirium after cardiac surgery in patients. Method The Control group was given routine nursing, observe group based on the given cluster management, including staff training, assessment scale for use and evaluation of the frequency, time, precipitate delirium drug control and early anti anxiety drug using and nursing measures. Result To observe the occurrence of delirium group rate is only 5%, while the control group the incidence of delirium is 25%（P 〈 0.05）; compared to the duration of delirium, observation group of 8 cases of delirium in patients with short duration, only 1 patients were discharged from the hosPital after 3 months the symptoms disappeared. Conclusion Cluster management measures the comprehensive system of prevention and nursing measures and strong pertinence,of patients with delirium after cardiac surgery in early prevention, early discovery, early treatment, to avoid the occurrence of adverse and unexpected events.