老年肝癌患者术后谵妄的相关因素分析及护理对策

李健平，唐娟，李秋琴，韦莉，王苏

广西壮族自治区肿瘤医院肝胆外科，广西南宁530021

[摘要]目的探析影响老年肝癌病人术后谵妄的相关因素和护理措施研究。方法整群选取该院2012年7月—2014年6月老年肝癌病人248例，探析其出现术后谵妄情况、相关影响因素和护理措施。结果老年肝癌病人248例，出现术后谵妄30例，占12.1%；老年肝癌病人术后谵妄的发生与年龄、合并症、阿片类、抗胆碱能药物应用、术中低血流量、术后疼痛、睡眠障碍、低氧血症等因素密切相关，差异有统计学意义（P<0.05）。结论老年肝癌病人术后谵妄的发生与年龄、合并症、阿片类、抗胆碱能药物应用、术中低血流量、术后疼痛、睡眠障碍、低氧血症等因素密切相关。

[关键词]护理措施；影响因素；术后谵妄；肝癌

[中图分类号]R47

[文献标识码]A

[文章编号]1674-0742（2015）10（a）－0170-03

[作者简介]李健平（1973-),女,广西容县人，本科，主管护师，主要从事肝胆胰脾肿瘤护理工作。

Abstract[]Objective To investigate the influencing factors of postoperative delirium in elderly patients with liver cancer and the corresponding nursing intervention.Methods 248 elderly patients with liver cancer admitted in our hospital from July 2012 to June 2014 were selected.The status of postoperative delirium, influencing factors of postoperative delirium in the patients and corresponding nursing intervention were investigated.Results Of the 248 elderly patients with liver cancer, 30 cases had postoperative delirium, accounting for 12.1%.The incidence of postoperative delirium in these patients was closely related to age, complications, application of opioid and anticholinergic drugs, intraoperative low blood flow, postoperative pain, sleep disorders, hyoxemia and other factors and the difference was statistically significant(P<0.05).Conclusion The incidence of postoperative delirium in elderly patients with liver cancer was closely related to age, complications, application of opioid and anticholinergic drugs, intraoperative low blood flow, postoperative pain, sleep disorders, hyoxemia and other factors.

收稿日期：（2015-07-04）

Related Factors of Postoperative Delirium in Elderly Patients with Liver Cancer and the Corresponding Nursing Intervention

LI Jian-ping, TANG Juan, LI Qiu-qin, WEI Li, WANG Su

Department of Hepatobiliary Surgery, Guangxi Cancer Hospital, Nanning, Guangxi Zhuang Autonomous Region, 530021 China

[Key words]Nursing intervention; Influencing factors; Postoperative delirium; Liver cancer

术后谵妄又名急性意识障碍，合并器质性短暂性睡眠周期、精神运动、记忆、思维、感觉、注意力障碍的脑部综合征。住院病人出现术后谵妄可达10%-50%[1]。术后谵妄是排除性诊断，本身并不遗留后遗症，但术后谵妄可造成病人心率增快、血压升高，增加创口出血、创口裂开、各种导管意外拔除、延长住院时间等情况，对病人的临床治疗效果和生命质量造成严重影响[2]。有文献显示，老年肝癌病人术后谵妄的发生与年龄、合并症、阿片类、抗胆碱能药物应用、术中低血流量、术后疼痛、睡眠障碍、低氧血症等因素密切相关[3]。探析老年肝癌病人术后谵妄的相关影响因素和护理措施具有重要的临床价值，故该院探析2012年7月—2014年6月老年肝癌病人术后谵妄的发生情况、相关影响因素、护理措施，效果满意，现报道如下。……