李彩花　刘晓宁　李娜　彭秋梅

【摘要】 目的：观察手术室风险护理对老年人全麻手术后认知功能的影响。方法：选择2018年1-12月于笔者所在医院进行全麻手术患者411例。按照随机数表法将其分为两组，其中对照组205例，均在全麻下进行常规护理;试验组206例，均在全麻下实施手术室护理。评价两组手术时间、自主呼吸恢复时间、苏醒时间，拔管后即刻及拔管后1、3、24 h认知功能。结果：两组患者的手术时间、术中出血量、恢复呼吸时间和苏醒时间比较，差异均无统计学意义（P>0.05）。两组PaCO2水平比较，差异无统计学意义（P>0.05）。试验组PaO2水平高于对照组，差异有统计学意义（P<0.05）。试验组拔管后即刻及拔管后1、3、24 h认知功能评分均高于对照组，差异有统计学意义（P<0.05）。结论：手术室风险护理可以显著改善老年人全麻手术后的认知功能，值得临床推广使用。

【关键词】 手术室风险护理; 老年人; 全麻手术; 认知功能

doi：10.14033/j.cnki.cfmr.2019.16.033 文献标识码 B 文章编号 1674-6805（2019）16-00-03

【Abstract】 Objective：To observe the effect of risk nursing in operating room on cognitive function of elderly patients after general anesthesia.Method：A total of 411 patients who underwent general anesthesia in our hospital from January to December 2018 were selected.According to the random number table method，they were divided into two groups，205 cases in the control group were given routine nursing under general anesthesia，and 206 cases in the experimental group were given operation room nursing under general anesthesia.The operation time，recovery time of spontaneous breathing and recovery time were observed，and the cognitive function was evaluated immediately after extubation and 1，3 and 24 hours after extubation.Result：There was no significant difference between the two groups in operation time，intraoperative bleeding volume，recovery breathing time and recovery time between the two groups（P>0.05）.There was no significant difference in PaCO2 level between the two groups（P>0.05）.The PaO2 level in the experimental group was higher than that in the control group，the difference was statistically significant（P<0.05）.The cognitive function scores of the experimental group were higher than those of the control group immediately after extubation and 1，3 and 24 h after extubation，the difference were statistically significant（P<0.05）.Conclusion：Operating room risk nursing can significantly improve the cognitive function of the elderly after general anesthesia surgery，and it is worthy of clinical application.

【Key words】 Operating room risk nursing; Elderly people; General anesthesia surgery; Cognitive function

First-authors address：Huidong Peoples Hospital，Huidong 516300，China

術后认知功能障碍作为一种常发于术后记忆、语言、计算和理解判断方面受损的中枢神经系统并发症，极大的影响患者日常生活[1]。术后认知功能障碍发生会导致并发症增加，延长其住院时间，直接影响患者术后康复时间，增加其住院费用[2-3]。

相关数据调查发现，60岁以上的全麻手术患者术后发生术后认知功能障碍高达25%，术后认知功能障碍会影响患者身体恢复，因此对于老年患者，必须加强其手术室护理，结合患者的具体情况，制定科学合理的护理方案，提高患者的认知能力[4-5]。本研究通过分析手术室风险护理对老年人全麻手术后认知功能的影响，旨在为临床改善老年患者全麻手术后认知功能提供理论基础，现报告如下。

1 资料与方法

1.1 一般资料