转子间骨折患者谵妄预防护理方案的有效性评价

Effectiveness Evaluation of Nursing Plan for Preventing Delirium in Patients with Intertrochanteric Fractures

摘要: 目的：本研究旨在调查谵妄预防护理方案对髋部骨折患者疼痛、功能状态、睡眠质量和谵妄预防的有效性。方法：该试验在新疆医科大学第六临床医学院实行，共有56名患者通过不同干预方式分配到两组。干预组(n = 21)按方案接受护理，对照组(n = 35)接受标准护理。研究数据使用基础信息统计表，使用重症监护室意识模糊评估方法(CAM-ICU)评估巴塞尔指数(BI)、理查兹–坎贝尔睡眠问卷(RCSQ)和视觉模拟评分法(VAS)。结果：患者出院前的疼痛评分(VAS)、功能状态(BI)以及睡眠评分(RCSQ)较刚入院时的好转，说明两种护理方案均能够对患者起效，然而我们的谵妄预防干预组的VAS、BI和RCSQ较对照组明显好转，差异具有统计学意义(P < 0.05)；此外，对比两组围术期发生谵妄事件的概率，谵妄干预护理组未发生干预，而对照组发生了6例，两组间的差异具有统计学意义(P < 0.05)。结论：谵妄预防护理方案有助于实现谵妄的早期发现和治疗，降低老年转子间骨折患者术后谵妄发生率，提高患者的生活自理能力，改善其睡眠质量，有一定的应用价值。

Abstract: Objective: The purpose of this study was to investigate the effectiveness of delirium preventive care options in pain, functional status, sleep quality, and delirium prevention in patients with hip fractures. Methods: The trial was conducted at the Sixth Clinical Medical College of Xinjiang Medical University, and a total of 56 patients were assigned to two groups through different intervention methods. The intervention group (n = 21) received care according to the plan, and the control group (n = 35) received standard care. The study data used basic information statistical tables, and the Basel Index (BI), Richards-Campbell Sleep Questionnaire (RCSQ) and Visual Analog Scale (VAS) were assessed using the Intensive Care Unit Confusion Assessment (CAM-ICU). Results: The patient’s pain score (VAS), functional status (BI), and sleep score (RCSQ) before discharge were improved compared with those at first admission, indicating that both nursing options can work for the patient. However, the VAS, BI and RCSQ in our delirium prevention intervention group were significantly improved compared with the control group, with statistical significance (P < 0.05); in addition, the probability of peri-operative delirium events was compared between the two groups. No intervention occurred in the delirium intervention nursing group, while 6 cases occurred in the control group. The difference between the two groups was statistically significant (P < 0.05). Conclusion: Delirium preventive nursing plan can help achieve early detection and treatment of delirium, reduce the incidence of postoperative delirium in elderly patients with intertrochanteric fractures, improve patients’ self-care ability, and improve their sleep quality. It has a certain application value.