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| 基于快速康复外科理念的四级早期活动对心脏瓣膜置换术后谵妄发生的预防 |
| Prevention of four-stage early activities based on the concept of rapid rehabilitation surgery on delirium after cardiac valve replacement |
| 收稿日期：2023-02-17 |
| DOI：10.20047/j.issn1673-7210.2024.02.37 |
| 关键词: 早期活动 心脏瓣膜置换术 谵妄 快速康复外科理念 |
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| 摘要:目的 探讨基于快速康复外科理念的四级早期活动对预防心脏瓣膜置换术后谵妄发生的效果。 方法 选取新疆医科大学第一附属医院2020年11月至2022年7月拟行心脏瓣膜置换术治疗的患者100例进行研究。通过随机数字表法将其分为对照组和观察组，各50例。对照组接受常规护理措施，观察组在对照组基础上给予基于快速康复外科理念的四级早期活动。采用重症监护谵妄筛查量表评估两组术后7 d内谵妄发生情况；记录谵妄首次发生时间及持续时间；比较两组住院时间及机械通气时间。 结果 术后7 d内，对照组共发生谵妄26例，占比52%；观察组共发生谵妄16例，占比32%。观察组谵妄发生率低于对照组，差异有统计学意义（P＜0.05）；观察组谵妄首次发生时间、谵妄持续时间均短于对照组，差异有统计学意义（P＜0.05）；观察组住院时间短于对照组，差异有统计学意义（P＜0.05）。 结论 基于快速康复外科理念的四级早期活动可减少心脏瓣膜置换术患者术后谵妄发生，缩短谵妄持续时间，减少谵妄相关不良事件的发生，缩短住院时间。 |
| Abstract:Objective To explore the effect of four-stage early activities based on the concept of rapid rehabilitation surgery on the prevention of delirium after cardiac valve replacement. Methods A total of 100 patients who were scheduled to undergo cardiac valve replacement in the First Affiliated Hospital of Xinjiang Medical University from June 2020 to July 2022 were selected for this study. They were divided into control group and observation group by random number table method, with 50 cases in each group. The patients in the control group received routine nursing measures, and the patients in the observation group were given a four-stage early activity based on the concept of rapid rehabilitation surgery on the basis of the control group. The critical care delirium screening scale was used to evaluate the occurrence of delirium within seven days after surgery, and the first occurrence and duration of delirium were recorded. The length of hospital stay and mechanical ventilation were compared between the two groups. Results Within seven days after operation, 26 cases (52%) of the control group had delirium. There were 16 cases of delirium in the observation group, accounting for 32%. The incidence of delirium in the observation group was lower than that in the control group, the difference was statistically significant (P＜0.05). The first occurrence time and duration of delirium in the observation group were shorter than those in the control group, and the differences were statistically significant (P＜0.05). The hospitalization time of observation group was shorter than that of control group, the difference was statistically significant (P＜0.05). Conclusion The four-stage early activity based on the concept of rapid rehabilitation surgery can reduce the occurrence of postoperative delirium, shorten the duration of delirium, reduce the incidence of delirium related adverse events, and shorten the duration of hospitalization in patients undergoing cardiac valve replacement. |
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