生命项目干预方案对心脏外科术后患者ICU获得性谵妄和衰弱的干预效果

Effects of hospital elderly life program to prevent the ICU-acquired delirium and weakness in patients after cardiac surgery

目的分析生命项目干预方案在心脏外科术后ICU住院患者中的应用价值,为改善患者预后提供参考。方法本研究为前瞻性研究。便利抽样选取2020年4月至2022年2月在乐山市人民医院住院的84例心脏外科术后进入ICU接受治疗的患者,按照入组时间分为对照组和观察组各42例。2组患者均给予常规护理,对照组实施谵妄、衰弱预防性常规护理,观察组实施生命项目干预方案。评价2组ICU获得性谵妄和衰弱发生率、机械通气时间、ICU住院时间、总住院时间以及重症监护体验得分情况。结果最终对照组纳入42例,观察组纳入39例。观察组ICU获得性谵妄发生率和ICU获得性衰弱发生率分别为17.95%(7/39)和7.69%(3/39),低于对照组的38.10%(16/42)和23.81%(10/42),差异均有统计学意义(χ^(2)=4.04、3.90,均P<0.05);观察组谵妄持续时间为(1.71±0.95)d,少于对照组的(2.81±1.05)d,差异有统计学意义(t=2.38,P<0.05);观察组机械通气时间、ICU住院时间、总住院时间及重症监护体验总分分别为(193.54±21.67)h、(9.49±2.11)d、(18.10±3.12)d、(2.72±0.26)分,少于对照组的(214.50±27.25)h、(10.90±1.97)d、(20.59±4.07)d、(3.15±0.35)分,差异均有统计学意义(t值为3.11~6.35,均P<0.05)。结论生命项目干预方案可降低心脏术后ICU住院患者ICU获得性谵妄和衰弱发生率,缩短机械通气和住院时间,减轻重症监护体验的不适感。

Objective To explore the applications value of hospital elderly life program in cardiac surgery patients in intensive care unit,and provide reference for improving the prognosis of patients.Methods This was a prospective study.A total of 84 cardiac surgery patients in intensive care unit from April 2020 to February 2022 in the People′s Hospital of Leshan by convenient sampling method,they were enrolled and divided into the observation group and the control group according to the admission time,each group was 42 cases.Routine nursing care was carried out in both groups,the control group implemented delirium and debility prevention nursing,the observation group adopted hospital elderly life program.The incidence of ICU-acquired delirium and weakness,mechanical ventilation time,duration of ICU stay,the total length of stay and intensive care experience were assessed between the two groups.Results The 42 cases were included in the final control group and 39 cases in the observation group.The incidence of ICU-acquired delirium and weakness were 17.95%(7/39)and 7.69%(3/39)in the observation group,lower than in the control group 38.10%(16/42)and 23.81%(10/42),the differences were statistically significant(χ2=4.04,3.90,both P<0.05);the duration of ICU delirium were(1.71±0.95)d in the observation group,shorter than in the control group(2.81±1.05)d,the difference was statistically significant(t=2.38,P<0.05);the mechanical ventilation time,duration of ICU stay,the total length of stay,the total score of intensive care experience in hospital in the observation group were(193.54±21.67)h,(9.49±2.11)d,(18.10±3.12)d,(2.72±0.26)points,lower than those in the control group(214.50±27.25)h,(10.90±1.97)d,(20.59±4.07)d,(3.15±0.35)points,the differences were statistically significant(t values were 3.11-6.35,all P<0.05).Conclusions Hospital elderly life program can decrease the incidence of ICU-acquired delirium and weakness of cardiac surgery patients in intensive care unit,shorten mechanical ventilation time and hospitalization time,alleviate discomfort in the intensive care experience.