围手术期心理护理对老年骨伤患者术后认知功能障碍的影响

Effect of perioperative psychological nursing on postoperative cognitive dysfunction in elderly patients with bone injury

目的探讨围手术期心理护理对老年骨伤患者术后认知功能障碍(POCD)的影响。方法选取在我院行骨折内固定和关节置换术的老年骨伤患者200例为研究对象,将所有患者随机分为对照组和试验组,每组100例。对照组给予常规护理,试验组在对照组基础上给予围手术期心理护理。比较两组患者的护理效果,术前1 d、术后1、3 d的认知功能,并比较POCD的总发生率。结果试验组护理总有效率显著高于对照组(P<0.05);与术前1 d比较,两组患者术后1 d的MMSE评分均显著降低(P<0.05),但试验组患者术后1、3 d的MMSE评分均显著高于对照组(P<0.05);试验组患者POCD总发生率明显低于对照组(P<0.05)。结论围手术期心理护理能够有效提高老年骨伤患者POCD的治疗效果,降低POCD的发生率,值得临床推广应用。

Objective To investigate the effect of perioperative psychological nursing on postoperative cognitive dysfunction(POCD)in elderly patients with bone injury.Methods A total of 200 elderly patients with bone injury who underwent fracture internal fixation and joint replacement in our hospital were selected as research objects.All patients were randomly divided into control group and experimental group,with 100 cases in each group.The control group was given routine nursing,and the experimental group was given perioperative psychological nursing on the basis of the control group.The nursing effects,cognitive function at preoperative 1 d,postoperative 1,3 d of the two groups were compared,and the total incidence of POCD were compared.Results The total effective rate of nursing in the experimental group was significantly higher than that in the control group(P<0.05).Compared with 1 d before operation,the MMSE scores at postoperative 1 d in the two groups significantly decreased(P<0.05),but the MMSE scores at postoperative 1 and 3 d in the experimental group were significantly higher than those in the control group(P<0.05).The total incidence of POCD in the experimental group was significantly lower than that in the control group(P<0.05).Conclusion Perioperative psychological nursing can effectively improve the treatment effect of POCD in elderly patients with bone injury and reduce the incidence of POCD,which is worthy of clinical promotion and application.