基于ABCDE的集束化、个性化护理方案对老年急性A型主动脉夹层病人术后谵妄的影响

doi:10.3969/j.issn.1003-9198.2024.04.021

摘要/Abstract

摘要： 目的探讨ABCDE集束化、个性化护理方案对老年急性A型主动脉夹层(ATAAD)病人术后谵妄的影响。方法选取2018—2021年在我院行外科手术治疗并入住ICU的121例>60岁老年ATAAD病人为研究对象,其中2018—2019年入院的60例病人为对照组,2020—2021年入院的61例病人为干预组。对照组给予常规ABCDE集束化护理方案,干预组给予基于ABCDE集束化管理方案制定的针对老年病人的个性化术后护理方案。对比2组病人术后谵妄发生率、谵妄发生的时间点、谵妄持续时间、机械通气时间、ICU住院时间和总住院时间。结果干预组谵妄的发生率及持续时间、机械通气时间、ICU住院时间均显著少于对照组,发生谵妄的时间点明显迟于对照组,差异有统计学意义(均P<0.05),2组间总住院时间差异无统计学意义(P>0.05)。结论基于ABCDE集束化管理方案制定的针对老年病人的个性化术后护理方案能有效推迟老年ATAAD病人术后谵妄的发生,并降低术后谵妄的发生率及持续时间,缩短机械通气时间及ICU住院时间,值得在临床广泛推广应用。

关键词: 术后谵妄, 主动脉夹层, 老年人, ABCDE集束化策略, 个性化护理

Abstract: Objective To explore the effect of individualized nursing plan based on ABCDE bundle on postoperative delirium in the elderly patients with acute type A aortic dissection(ATAAD). Methods A total of 121 elderly patients with ATAAD who underwent surgery and admitted to intensive care unit (ICU) in our hospital from January 2018 to December 2021 were enrolled in this study. Among them, 60 patients admitted from January 2018 to December 2019 who received the conventional ABCDE bundle care were enrolled in the control group, and 61 patients admitted from January 2020 to December 2021 who received individualized postoperative care plan based on ABCDE bundle were enrolled in the intervention group. The incidence of postoperative delirium, the time point of delirium occurrence, the duration of delirium, the duration of mechanical ventilation, the length of ICU stay and the total length of hospital stay were compared between the two groups. Results The incidence of postoperative delirium, the duration of delirium, the duration of mechanical ventilation and the length of ICU stay were significantly lower, and the time point of delirium occurrence was significantly later in the intervention group than that in the control group(P<0.05). The total length of hospital stay showed no significant difference between the two groups. Conclusions The individualized postoperative nursing plan for elderly ATAAD patients based on ABCDE bundle can effectively delay the occurrence of postoperative delirium, reduce the incidence and duration of postoperative delirium, shorten the duration of mechanical ventilation and ICU stay, which is worthy of clinical application.

Key words: postoperative delirium, aortic dissection, aged, ABCDE bundle, individualized nursing

中图分类号:

R 473

祁萍. 基于ABCDE的集束化、个性化护理方案对老年急性A型主动脉夹层病人术后谵妄的影响[J]. 实用老年医学, 2024, 38(4): 418-421.

QI Ping. Effect of individualized ABCDE-based bundle care on postoperative delirium in elderly patients with acute type A aortic dissection[J]. Practical Geriatrics, 2024, 38(4): 418-421.

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