早期干预对预防择期手术患者谵妄的效果研究

Effect of early intervention on prevention of delirium in patients with elective surgery

目的 探讨早期干预对预防择期手术患者谵妄的效果.方法 选取2016年10月至2018年6月入院行择期手术且术后入住ICU的患者200例,根据预约床位的日期,单号100例进入观察组,双号100例进入对照组.对照组由病房、手术室、ICU护士行手术常规护理;观察组在对照组的基础上由ICU早期干预组在术前1 d进行干预.比较2组患者谵妄发生率、谵妄持续时间、ICU住院时数及满意度和患者焦虑程度之间的差异.结果 观察组谵妄发生率、谵妄持续时间、ICU住院时数、ICU住院满意度、焦虑评分分别为16%(16/100)、4(3.1,10.6)h、(33.06 ± 16.06)h、(56.25 ± 5.74)分、(50.17 ± 1.56)分,对照组分别为29%(29/100)、12(9.2,14.6)h、(39.96 ± 25.47)h、(41.59 ± 4.94)分,(52.37 ± 3.52)分,差异有统计学意义(χ2=4.129,Z=-2.757,t=2.291、-19.349、5.718,均P<0.05).结论 ICU医护人员早期干预择期手术患者,能有效预防和减少谵妄的发生,缓解患者焦虑,缩短谵妄持续时间和ICU住院时数,提高住院满意度.

Objective To investigate the effect of early intervention on the prevention of delirium in patients undergoing elective surgery.Methods Totally 200 patients scheduled for surgery and admitted to ICU during Oct.2016 to Jun.2018 were assigned to two groups(n=100).Both the observation group(group A)and the control group(group B)received routine nursing care from wards,operating room and ICU nurses.In addition,the observation group(group A)were intervened by ICU nurses by means of nursing measures to prevent delirium the day before surgery.The differences of delirium incidence,delirium duration,and length of stay in ICU,satisfaction and anxiety scores between the two groups were measured.Results The incidence and duration of delirium,length of stay in ICU,satisfaction rate of ICU,S-AI scores between group A and B were 16%(16/100)vs.29%(29/100),4(3.1,10.6)h vs.12(9.2,14.6)h,(33.06±16.06)h vs.(39.96±25.47)h and(56.25±5.74)vs.(41.59±4.94),(50.17±1.56)vs.(52.37±3.52)respectively(χ2=4.129,Z=-2.757,t=2.291,-19.349,5.718,all P<0.05).Conclusion Early intervention can effectively prevent and reduce the incidence of ICU delirium in patients undergoing elective surgery.