【摘要】：目的提高老年髖部骨折患者術(shù)后譫妄的護(hù)理質(zhì)量。方法建立多學(xué)科合作團(tuán)隊(duì),參照2014美國(guó)老年醫(yī)學(xué)會(huì)提供的防治老年患者術(shù)后譫妄臨床指南,通過術(shù)前氧療同期配合呼吸功能訓(xùn)練、術(shù)中灌注平衡與體溫控制及限制性輸血、術(shù)后多模式鎮(zhèn)痛與綜合睡眠管理,實(shí)施專業(yè)化、系統(tǒng)化圍手術(shù)期譫妄管理方案,降低老年髖部骨折患者術(shù)后譫妄發(fā)生率。結(jié)果實(shí)驗(yàn)組和對(duì)照組術(shù)后譫妄發(fā)生率分別為16.36%(9/55)和30.91%(17/55),譫妄持續(xù)時(shí)間分別為(3.37±1.21)d和(4.53±1.87)d,術(shù)后低氧血癥發(fā)生率分別為9.09%(5/55)和14.55%(8/55),同時(shí)術(shù)后每日總睡眠時(shí)間分別為(5.18±0.53)h和(3.56±0.69)h。結(jié)論圍手術(shù)期譫妄管理方案融入了多項(xiàng)護(hù)理應(yīng)對(duì)策略及質(zhì)量持續(xù)改進(jìn)項(xiàng)目,縮短了老年髖部骨折患者術(shù)后首次下床時(shí)間和平均住院日,降低了術(shù)后譫妄發(fā)生率。
[Abstract]:Objective to improve the nursing quality of postoperative delirium in elderly patients with hip fracture. Methods to establish a multi-disciplinary cooperative team, referring to the clinical guidelines for the prevention and treatment of postoperative delirium in elderly patients provided by the American Association of Geriatrics in 2014, through preoperative oxygen therapy combined with respiratory function training, intraoperative perfusion balance, body temperature control and restricted blood transfusion. After operation, multi-mode analgesia and comprehensive sleep management, professional and systematic management of delirium during perioperative period were carried out to reduce the incidence of postoperative delirium in elderly patients with hip fracture. Results the incidence of postoperative delirium was 16.36% (9 鈮，

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