ABCDEF集束化护理策略对心脏外科术后谵妄发生率和持续时间的影响

The effect of ABCDEF cluster nursing strategy on the incidence and duration of delirium after cardiac surgery

目的 分析ABCDEF集束化护理策略在心脏外科术后患者中的应用及对患者术后谵妄发生情况的影响。方法 选取2020年6月—2022年6月宁波市第二医院重症医学科收治的120例心脏外科术后患者作为研究对象,根据随机数字表法将其分为对照组和观察组各60例。对照组患者应用常规护理,观察组在对照组基础上应用ABCDEF集束化护理策略。比较2组患者术后谵妄风险评分及发生情况、护理前后睡眠质量及疼痛程度、机械通气时间、ICU停留时间及住院时间。结果 入院时及术前1 d, 2组患者谵妄风险评分比较差异无统计学意义(P>0.05);随着时间的延长,2组谵妄风险评分比较差异有统计学意义(F组间=10.233,P组间<0.001);观察组患者谵妄发生率为10.0%(6/60),低于对照组的30.0%(18/60),且观察组患者谵妄持续时间短于对照组(P<0.05)。护理后,观察组睡眠质量及疼痛程度评分分别为8(3,12)分、(1.95±1.21)分,均低于对照组的12(7,16)分、(2.56±1.21)分,均P<0.05;且观察组患者机械通气时间、ICU停留时间及住院时间均少于对照组(均P<0.05)。结论 ABCDEF集束化护理策略可降低心脏外科术后患者谵妄发生率及谵妄持续时间,减轻患者术后疼痛,并能提高睡眠质量,减少患者住院时间。

Objective To analyze the application of ABCDEF cluster nursing strategy in patients after cardiac surgery and its impact on postoperative delirium.Methods A total of 120 patients after cardiac surgery admitted to the Department of Critical Care of Ningbo Second Hospital from June 2020 to June 2022 were selected as the study subjects.They were divided into control group and observation group of 60 cases each according to the random number table method.The patients in the control group were treated with routine nursing,while the patients in the observation group were treated with ABCDEF cluster nursing strategy on the basis of the control group.The risk score and occurrence of postoperative delirium,sleep quality and pain severity before and after nursing were compared between the two groups,as well as the duration of mechanical ventilation,ICU stay and hospital stay.Results There was no significant difference in delirium risk score between the two groups at admission and 1 day before operation(P>0.05);With the extension of time,the difference of delirium risk score between the two groups was statistically significant(F between groups=10.233,P between groups<0.001);The incidence of delirium in the observation group was 10.0%(6/60),lower than 30.0%(18/60)in the control group,and the duration of delirium in the observation group was shorter than that in the control group(P<0.05).After nursing,the scores of sleep quality and pain degree in the observation group were 8(3,12)points and(1.95±1.21)points respectively,which were lower than those in the control group[12(7,16)points and(2.56±1.21)points,all P<0.05];The mechanical ventilation time,ICU stay and hospital stay of patients in the observation group were less than those in the control group(all P<0.05).Conclusion The ABCDEF cluster nursing strategy can reduce the incidence and duration of delirium in patients after cardiac surgery,reduce postoperative pain,improve sleep quality and reduce hospital stay.