摘 要
术后谵妄是老年患者常见且严重的并发症，严重影响患者康复进程及预后。本研究旨在探讨综合护理干预对老年患者术后谵妄发生率、持续时间及严重程度的影响。选取某三甲医院2019年1月至2021年12月期间收治的480例老年手术患者为研究对象，按照随机数字表法分为观察组和对照组各240例，对照组接受常规护理，观察组在常规护理基础上实施包括环境优化、早期活动、认知训练、家属参与等多方面的综合护理干预。结果表明，观察组术后谵妄发生率为15.42%，明显低于对照组的27.50%，差异有统计学意义(P0.05)；且观察组谵妄持续时间较短、严重程度较低。这说明综合护理干预可有效降低老年患者术后谵妄的发生率，缩短其持续时间并减轻严重程度，为临床预防和治疗老年患者术后谵妄提供了新的思路与方法。
关键词：术后谵妄，综合护理干预，老年患者
Analysis of nursing intervention effect on postoperative delirium in elderly patients
Abstract
Postoperative delirium is a common and serious complication in elderly patients, which seriously affects the recovery process and prognosis of patients. The purpose of this study was to investigate the effects of comprehensive nursing intervention on the incidence, duration and severity of postoperative delirium in elderly patients. A total of 480 elderly surgery patients admitted to a Grade-A hospital from January 2019 to December 2021 were selected as the study ob jects, and were divided into the observation group and the control group with 240 cases each according to random number table method. The control group received routine care. On the basis of routine nursing, the observation group implemented comprehensive nursing intervention including environmental optimization, early activity, cognitive training, family participation and so on. The results showed that the incidence of postoperative delirium in the observation group was 15.42%, which was significantly lower than that in the control group (27.50%), the difference was statistically significant (P0.05). The duration and severity of delirium were shorter in the observation group. This indicates that comprehensive nursing intervention can effectively reduce the incidence of postoperative delirium in elderly patients, shorten its duration and reduce its severity, and provide a new idea and method for clinical prevention and treatment of postoperative delirium in elderly patients.
Key Words：postoperative delirium, comprehensive nursing intervention, elderly patients
目 录
一、绪论 1
（一）研究背景及意义 1
（二）研究老年患者术后谵妄的意义 1
二、老年患者术后谵妄的影响因素分析 2
（一）年龄与术后谵妄的关系 2
（二）手术类型对谵妄的影响 3
（三）既往病史与术后谵妄 4
（四）心理因素对谵妄的作用 6
三、护理干预措施的实施与评估 7
（一）早期活动干预效果 7
（二）环境调整干预措施 8
（三）家属参与护理模式 9
（四）多学科协作护理方案 10
四、护理干预效果的综合评价 12
（一）干预前后谵妄发生率对比 12
（二）患者康复速度的变化 13
（三）医护人员工作负担分析 14
（四）患者及家属满意度调查 15
五、结论 17
参考文献 18
致 谢 20
