围术期精神状态评估在骨科老年患者术后精神障碍预防护理中的效果分析
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摘要
目的:探讨围术期精神状态评估在骨科老年患者术后精神障碍预防护理中的临床效果。方法:将208例老年骨科手术患者随机分为观察组、对照组各104例。对照组在围术期给予常规护理,观察组在常规护理的基础上给予围术期精神状态评估,根据患者的精神状态调整护理干预。结果:观察组发生精神功能障碍12例(11.5%),症状持续时间(2.12±0.62)天;对照组发生精神功能障碍24例(23.1%),症状持续时间(4.78±2.56)天。精神功能障碍发生率、症状持续时间2组比较差异有统计学意义(P<0.05)。对照组出现意外拔管8例(7.7%),护理满意率89.4%(93/104);观察组未出现意外拔管,护理满意率98.1%(102/104)。意外拔管发生率及护理满意度2组比较差异有统计学意义(P<0.05)。结论:对骨科老年患者进行围术期精神状态评估,并根据患者的精神状态设计和调整临床护理途径,有助于预防术后精神功能障碍,提高护理满意度。
Objective: To explore clinical effects of perioperative mental state assessment in the prevention and care for senile patients in orthopedics. Methods: All 208 senile patients were randomized into the observation group and the control group, 104 cases each group. The control group accepted perioperative conventional care, and the observation group received perioperative mental state assessment on the basis of conventional care, nursing intervention was adjusted according to the patients′ mental state. Results: There were 12 cases with mental disorder in the observation group(11.5%), duration of symptoms(DOS)(2.12 ±0.62) days; 24 cases with mental disorder in the control group(23.1%), DOS(4.78 ±2.56) days. The difference had statistical meaning in the comparisons of the incidence of mental disorder and DOS between both groups(P <0.05). There were eight cases with accidental extubation(7.7%) and nursing satisfaction rate of the control group was 89.4%(93/104); and there was no accidental extubation in the observation group and nursing satisfaction rate was 98.1%(93/104). The difference had statistical meaning in the comparisons of the incidences of accidental extubation and nursing satisfaction rate(P<0.05). Conclusion: Performing perioperative mental state assessment for senile patients, designing and adjusting clinical nursing pathway according to mental state of the patients are helpful to prevent postoperative mental disorder and improve nursing satisfaction degrees.
Objective: To explore clinical effects of perioperative mental state assessment in the prevention and care for senile patients in orthopedics. Methods: All 208 senile patients were randomized into the observation group and the control group, 104 cases each group. The control group accepted perioperative conventional care, and the observation group received perioperative mental state assessment on the basis of conventional care, nursing intervention was adjusted according to the patients′ mental state. Results: There were 12 cases with mental disorder in the observation group(11.5%), duration of symptoms(DOS)(2.12 ±0.62) days; 24 cases with mental disorder in the control group(23.1%), DOS(4.78 ±2.56) days. The difference had statistical meaning in the comparisons of the incidence of mental disorder and DOS between both groups(P <0.05). There were eight cases with accidental extubation(7.7%) and nursing satisfaction rate of the control group was 89.4%(93/104); and there was no accidental extubation in the observation group and nursing satisfaction rate was 98.1%(93/104). The difference had statistical meaning in the comparisons of the incidences of accidental extubation and nursing satisfaction rate(P<0.05). Conclusion: Performing perioperative mental state assessment for senile patients, designing and adjusting clinical nursing pathway according to mental state of the patients are helpful to prevent postoperative mental disorder and improve nursing satisfaction degrees.
引文
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[12]李春花,安东莲,田芮溪,等.老年腹部手术患者术后精神障碍危险因素及护理干预[J].陕西医学杂志,2017,46(5):678-679.
[13]Celiktas M,Togrul E,Kose O.Calcar preservation arthroplasty for unstable intertrochanteric femoral fractures in elderly[J].Clin Orthop Surg,2015,7(4):436-442.
[14]黄泽慧,黄燕.老年精神障碍患者住院期间的安全隐患及护理应对策略[J].中国中医急症,2017,26(4):750-752.
[15]王芳,刘红侠,袁莲芳,等.老年髋部骨折复位术后并发精神障碍的影响因素分析及护理对策[J].国际精神病学杂志,2016,43(6):1083-1085.
[2]Sharma D,Hayman K,Stewart BT,et al.Surgery for conditions of infectious etiology in resource-limited countries affected by crisis:The medecins sans frontieres operations centre brussels experience[J].Surg Infect(Larchmt),2015,16(6):721-727.
[3]张莹莹,王春雪.护理干预在130例骨科老年患者术后认知功能障碍中的应用[J].重庆医学,2013,42(8):856-857.
[4]Jung HS,Park SM,Kim GU,et al.Unique imaging features of spinal neurenteric cyst[J].Clin Orthop Surg,2015,7(4):515-518.
[5]Cho JH,Ha JK,Hwang CJ,et al.Patterns of treatment for metastatic pathological fractures of the spine:the efficacy of each treatment modality[J].Clin Orthop Surg,2015,7(4):476-482.
[6]胡敏娟,胡志辉,谢维,等.心理护理干预在骨科老年患者术后精神障碍中的效果评价[J].医学临床研究,2014,31(5):958-963.
[7]苏瑞鉴,陈胜琼,黄海钦,等.骨科老年患者术后精神障碍风险因素识别和干预[J].实用骨科杂志,2013,19(11):1045-1047.
[8]许青.骨科老年患者80例的临床护理[J].中国基层医药,2014,21(19):3037-3038.
[9]Tsonga T,Michalopoulou M,Malliou P,et al.Analyzing the history of falls in patients with severe knee osteoarthritis[J].Clin Orthop Surg,2015,7(4):449-456.
[10]余江,蒋科,吴思宇,等.骨科老年患者围手术期并发症相关危险因素评估[J].第三军医大学学报,2013,35(11):1160-1163.
[11]钱彦,卢伟良,吴悦,等.不同麻醉方式对骨科老年患者术后认知功能的影响比较[J].中国基层医药,2014,21(10):1558-1559.
[12]李春花,安东莲,田芮溪,等.老年腹部手术患者术后精神障碍危险因素及护理干预[J].陕西医学杂志,2017,46(5):678-679.
[13]Celiktas M,Togrul E,Kose O.Calcar preservation arthroplasty for unstable intertrochanteric femoral fractures in elderly[J].Clin Orthop Surg,2015,7(4):436-442.
[14]黄泽慧,黄燕.老年精神障碍患者住院期间的安全隐患及护理应对策略[J].中国中医急症,2017,26(4):750-752.
[15]王芳,刘红侠,袁莲芳,等.老年髋部骨折复位术后并发精神障碍的影响因素分析及护理对策[J].国际精神病学杂志,2016,43(6):1083-1085.