系统性护理对老年患者术后认知功能障碍的预防效果

Preventive Effect of Systemic Nursing on Postoperative Cognitive Dysfunction in Elderly Patients

目的:探讨系统性护理对老年患者术后认知功能障碍(POCD)的预防效果.方法:选取2012年7月—2014年6月于祁阳市人民医院骨科行择期手术的老年患者183例作为研究对象,采用随机数字表法分为观察组(92例)和对照组(91例).对照组接受普通外科常规围术期护理,观察组在术后基于POCD进行系统性护理干预.比较两组患者简易精神状态量表(MMSE)和韦氏智力量表(WMS)评分,以及术后POCD、智力评估低下、再住院情况及护理满意度.结果:术后7 d,两组患者MMSE、WMS评分均低于术前,观察组高于对照组,差异有统计学意义(P<0.05);观察组术后POCD发生率、智力评估低下占比及再住院率低于对照组,差异有统计学意义(P<0.05);观察组护理满意度高于对照组,差异有统计学意义(P=0.001).结论:通过对老年术后患者进行系统性护理干预,可以有效降低POCD发生率,改善患者记忆、思维能力,提高患者满意度,值得临床推广.

Objective:To explore the preventive effect of systemic nursing on postoperative cognitive dysfunction(POCD)in elderly patients.Methods:A total of one hundred and eighty-three elderly patients who underwent elective surgery in the Department of Orthopedics of Qiyang People's Hospital from July 2012 to June 2014 were selected as the study objects,and were divided into observation group(92 cases)and control group(91 cases)by random number table method.The control group received routine perioperative nursing in general surgery,and the observation group received systemic nursing intervention based on POCD after surgery.The scores of summary mental state scale(MMSE)and Wechsler intelligence scale(WMS)scores,as well as postoperative POCD,low intelligence assessment,re-hospitalization and nursing satisfaction were compared between the two groups.Results:7 days after surgery,MMSE and WMS scores in 2 groups were lower than before surgery,and observation group was higher than control group,the difference was statistically significant(P<0.05);the incidence of POCD,the proportion of low intelligence assessment and the rate of re-hospitalization in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05);the nursing satisfaction of the observation group was higher than that of the control group,and the difference was statistically significant(P=0.001).Conclusion:Systemic nursing intervention for elderly postoperative patients can effectively reduce the incidence of POCD,improve the memory and thinking ability of patients,and improve patient satisfaction,which is worthy of clinical promotion.