综合干预应用于老年髋部骨折患者围术期谵妄的效果分析

Effect of comprehensive intervention on perioperative delirium in elderly patients with hip fracture

目的探讨综合干预对老年髋部骨折患者围术期谵妄的预防效果。方法根据随机数表法将2016年4月-2017年12月在该院行手术治疗的82例老年髋部骨折患者分为对照组和实验组，各41例。两组患者均接受骨科常规护理，实验组在此基础上开展综合干预，统计两组患者围术期谵妄、并发症发生情况及住院时间，并观察患者干预前、后疼痛程度及睡眠质量变化。结果实验组出院前谵妄发生率并发症发生率明显低于对照组，差异有统计学意义（P〈0．05）；实验组首末次谵妄严重程度评分（DRS）、谵妄持续时间及住院时间均较对照组低，差异有统计学意义（均P〈0．05）；实验组干预后视觉模拟评分量表（VAS）、匹兹堡睡眠质量指数量表（PSQI）评分较对照组低，差异均有统计学意义（均P〈0．05）。结论将综合干预应用于老年髋部骨折患者围术期中利于减少及预防谵妄发生，缩短住院时间，降低并发症发生风险，减轻疼痛程度，改善睡眠质量。

Objective To study the effect of comprehensive intervention on perioperative prevention of delirium in elderly patients with hip fracture. Methods According to the random number table method, 82 cases of elderly patients with hip fracture undergoing surgery from April 2016 to December 2017 in our hospital were divided into control group and experimental group. The patients in the control group received routine orthopedic nursing interventions, and the patients in the experimental group were given comprehensive nursing intervention on the basis of routine care. The perioperative delirium, complications and hospitalization time of the two groups were investigated. The changes of pain and sleep quality before and after intervention were observed. Results The incidence of delirium before discharge in the experimental group was lower than that in the control group, and the difference was statistically significant （P 〈 0. 05 ）. In the experimental group, the first and last delirium severity score （ DRS）, duration of delirium and hospitalization time were lower than those in the control group, and the differences were statistically significant （ P〈0. 05 ）. The visual analogue scale （VAS） and Pittsburgh sleep quality index （PSQI） score of the experimental group were lower than those of the control group after intervention, and the differences were statistically significant （P〈0. 05）. Conclusion Perioperative application of comprehensive nursing intervention in elderly patients with hip fracture can help to reduce and prevent the occurrence of delirium, shorten the length of hospital stay, reduce the risk of complications, reduce the degree of pain and improve the quality of sleep.