谵妄护理干预方案在脑肿瘤术后患者中的应用

Application of Delirium Nursing Intervention Program in Postoperative Patients with Brain Tumor

目的:探讨在脑肿瘤患者术后监护期间给予谵妄护理干预方案的临床效果。方法:选取2016年10月—2018年10月间在河南科技大学第一附属医院脑肿瘤手术患者200例。将这200例患者按照护理方式的不同分为对照组和观察组,每组各100例。根据相应研究以及实际情况拟出谵妄护理干预方案,并将该方案运用于100例脑肿瘤术后患者定为观察组,并以同期100例行术后常规护理的脑肿瘤患者为对照组。比较两组谵妄发生率以及谵妄持续时间,监护期间并发症发生情况,利用生活能力评价量表(ADL)评价两组患者术后以及术后6个月的生活能力。结果:观察组100例脑肿瘤术后患者,出现10例谵妄,发生率为10%;对照组100例脑肿瘤术后患者,出现21例谵妄,发生率为21%,两组之间比较差异有统计学意义(P<0.05)。观察这两组发生谵妄的患者年龄,全为70岁以上老年人,说明老年人是脑肿瘤术后发生谵妄的高危人群。观察组10例谵妄患者持续时间为(3.14±0.60)h,对照组21例谵妄患者持续时间为(10.25±2.30)h两组之间比较差异有统计学意义(P<0.05)。观察组脑肿瘤术后患者并发症发生率为8%,对照组脑肿瘤术后患者并发症发生率为25%,两组之间比较差异有统计学意义(P<0.05)。两组患者在术后生活能力量表(PSMS)、工具性生活能力量表(IADL)、ADL之间并没有显著的统计学意义,术后六个月,观察组PSMS、IADL、ADL评分显著优于对照组,两组之间比较差异有统计学意义(P<0.05)。结论:肿瘤患者术后运用谵妄护理干预方案,可以有效减少谵妄发生率、并发症发生率以及提高生活能力。

Objective: To explore the clinical effect of delirium nursing intervention program in postoperative care of brain tumor patients. Methods: 200 patients undergoing brain tumor surgery in the hospital from October 2016 to October 2018 were selected as research objects. The 200 patients were divided into control group and observation group according to different nursing methods, with 100 cases in each group. According to the corresponding research and actual situation, a delirium nursing intervention plan was drawn up, and the plan was applied to 100 patients with brain tumor after surgery as the observation group, and 100 patients with brain tumor who underwent routine postoperative care during the same period were used as the control group. The incidence of delirium, duration of delirium and complications during monitoring were compared between the two groups. The life ability scale(ADL)was used to evaluate the postoperative life ability of the two groups at 6 months after operation. Results: In the observation group, there were 10 cases of delirium occurred, the incidence was 10%. In the control group, there were 21 cases of delirium after brain tumor surgery, with an incidence of 21%. The difference between the two groups was statistically significant(P<0.05). The ages of patients with delirium in these two groups were all elderly people over 70 years old, indicated that the elderly were at high risk of developing delirium after brain tumor surgery. The duration of delirium was(3.14±0.60) h in the observation group and(10.25±2.30) h in the control group. Postoperative complication rate was 8% in the observation group and 25% in the control group, the difference between the two groups was statistically significant(P<0.05). There was no statistical significance between the two groups of patients on the PSMS, IADL, and ADL. At six months after the operation, the observation group had significant PSMS, IADL, and ADL scores, better than the control group, the difference between the two groups was statistically significant(P<0.05). Conclusion: Postoperative delirium nursing intervention program can effectively reduce the incidence of delirium, complications and improve the ability to live.