专职护理小组配合语言唤醒用于全身麻醉老年骨科手术患者对术后早期认知功能的影响

The effects of professional nursing group combined with language arousal on early postoperative cognitive function in elderly patients after orthopedic surgery under general anesthesia

目的观察专职护理小组配合语言唤醒用于全身麻醉老年骨科手术患者对术后早期认知功能的影响。方法选取2019年6月至2022年6月在我院行骨科手术治疗的232例患者,按照随机数字表法分为专职护理组(专职护理小组配合语言唤醒)和传统护理组(常规护理)各116例。比较两组围手术期情况、苏醒时间、不良事件发生情况及术后早期认知功能;以及两组疼痛水平和患者对护理工作的满意度。结果专职护理组手术准备时间、接送时间、睁眼时间、拔管时间及苏醒室停留时间均短于传统护理组(P<0.05);术后6、12 h时视觉模拟量表评分低于传统护理组(P<0.05);麻醉清醒即刻、术后1、12 h及术后1 d时简易智力状态检查量表评分高于传统护理组(P<0.05);躁动及跌床等不良事件发生率低于传统护理组(P<0.05);对各项护理工作满意度评分均高于传统护理组(P<0.05)。结论专职护理小组配合语言唤醒能保障全身麻醉老年骨科手术的运行效率,缩短患者麻醉清醒时间,减少手术及麻醉给患者认知功能带来的影响,且能有效降低术中及术后不良事件发生风险,缓解其术后疼痛水平,患者对各项护理工作的满意度也更高。

Objective To observe the effects of professional nursing group combined with language arousal on early cognitive function in elderly patients after orthopedic surgery under general anesthesia.Methods A total of 232 patients undergoing orthopedic surgery in our hospital were enrolled.The patients were randomly divided into a professional nursing group(professional nursing combined with language arousal)and a traditional nursing group(routine nursing)between June 2019 and June 2022,116 in each group.The perioperative conditions,recovery time,occurrence of adverse events and early postoperative cognitive function as well as changes of pain level and nursing satisfaction were compared between the two groups.Results The operation preparation time,picking up time,eye opening time,extubation time and stay time in recovery room in the professional nursing group were shorter than those in the traditional nursing group(P<0.05).After 6 and 12 hours of surgery,scores of visual analogue scale(VAS)in the professional nursing group were lower than those in the traditional nursing group(P<0.05).Immediately after anesthesia recovery and after 1 hour,12 hours and 1 day of surgery,scores of mini-mental state examination in the professional nursing group were higher than those in the traditional nursing group(P<0.05).The incidence of adverse events such as restlessness and falling bed in the professional nursing group was lower than that in the traditional nursing group(P<0.05).The scores of nursing satisfaction in the professional nursing group were higher than those in traditional nursing group(P<0.05).Conclusions Professional nursing group combined with language arousal can guarantee the operation efficiency of orthopedic surgery under general anesthesia,shorten the anesthesia recovery time and reduce the effects of surgery and anesthesia on cognitive function in elderly patients.It can also effectively reduce the risk of intraoperative and postoperative adverse events and alleviate postoperative pain.Patients are also more satisfied with various nursing tasks.