归脾汤治疗老年转子间骨折全麻术后谵妄的临床研究

Clinical study of Guipi Decoction in treatment of delirium after general anesthesia for elderly intertrochanteric fractures

目的探讨归脾汤对预防围术期老年转子间骨折术后谵妄发生的疗效。方法选取2020年1月至2021年4月广州市中西医结合医院骨科住院患者80例,随机分为对照组与试验组,每组各40例,对照组患者给予常规治疗,试验组在常规治疗基础上于入院后至术后第7天给予归脾汤口服。比较两组患者的谵妄发生率、谵妄持续时间,记录两组患者术后第1天Nurse-DESC谵妄评分等指标。结果试验组谵妄发生率为12.50%,对照组发生率为32.50%,两组比较,差异有统计学意义(P<0.05);试验组患者谵妄持续时间低于对照组,差异有统计学意义(P<0.05);术后两组间Nurse-DESC谵妄评分比较,差异无统计学意义(P>0.05);术后两组间发生谵妄时间比较,差异无统计学意义(P>0.05)。结论围术期应用归脾汤可降低高龄转子间骨折患者发生谵妄的概率,并同时减少患者术后谵妄持续时间。

Objective To explore the effect of Guipi Decoction on preventing postoperative delirium in elderly patients with intertrochanteric fracture during perioperative period.Methods A total of 80 patients treated in the Department of Orthopedics of Guangzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2020 to April 2021 were randomly divided into the control group and the experimental group,with 40 patients in each group.The control group were given conventional treatment,and the experimental group were given oral Guipi Decoction from admission to 7 days after surgery plus conventional treatment.The incidence of delirium and duration of delirium were collected and compared between the two groups.The Nurse-DESC delirium score and other indicators at 1 day after surgery in both groups were recorded.Results The incidence of delirium in the experimental group was 12.50%,and that in the control group was 32.50%,with statistically significant difference(P<0.05).The duration of delirium in the experimental group was lower than that in the control group,with statistically significant difference(P<0.05).There was no statistically significant difference in Nurse-DESC delirium score after surgery between the two groups(P>0.05).There was no significant difference in time to delirium after surgery between the two groups(P>0.05).Conclusion Perioperative application of Guipi Decoction can reduce incidence of delirium as well as duration of postoperative delirium in elderly patients with intertrochanteric fractures.