综合性护理干预对老年腹部手术患者全麻术后认知功能和并发症的影响

目的探讨综合性护理干预对老年腹部手术患者全麻术后认知功能和并发症的影响。方法选择老年腹部手术患者72例，随机分为护理干预组和常规护理组。两组均在气管插管全身麻醉下行手术治疗。常规护理组予以围手术期常规护理，护理干预组予以综合性护理干预。结果术后1d，两组患者MMSE和HDS评分均明显下降（P〈0．05），且护理干预组患者下降幅度少于常规护理组（P〈0．05）。术后3d，护理干预组患者MMSE和HDS评分恢复术前水平（P〉0．05），而常规护理组患者MMSE和HDS评分仍低于术前水平（P〈0．05）；同时护理干预组患者术后并发症的总发生率5．56％，明显低于常规护理组的22．22％（X^2=4．18，P〈0．05）。结论综合性护理干预对老年腹部手术患者全麻术后认识功能下降具有一定的改善作用，能减轻术后认知功能下降，并能减少术后并发症发生率。

nfluence of comprehensive nursing intervention on cognitive function and complication after general anesthesia of patients treated with elder ab- dominal operation

Objective To discuss influence of comprehensive nursing intervention on cognitive function and complication after general anesthesia of patients treated with elder abdominal operation. Methods Seventy-two cases of patients who were treated with elder abdominal operation by Department of General Surgery, were selected and divided into nursing intervention group and routine nursing group at random. The patients in two groups were operated in the treat- ment of general anesthesia by trachea cannula. The patients in routine nursing group were given routine nursing in perioperative period, while the patients in nursing intervention were additionally given comprehensive nursing interven- tion. Results The MMSE and HDS scores of patients in two groups obviously were declined after one day upon the operation （t=2.16, 2.35, 2.20, 2.29, P〈0.05）, and the declining rate in nursing intervention group was much lower than that in routine nursing group （t=2.19,2.12, P〈0.05）. MMSE and HDS scores of patients in nursing intervention group 3 days after operation were returned to the levels before the operation （P〉0.05）, while the MMSE and HDS scores of patients in routine nursing group were still lower than that before the operation （t=2.19,2.14, P〈0.05）. Meanwhile, the total clinical efficiency of postoperative complication of patients in nursing intervention group was 5.56%, which was much lower than that in routine nursing group （22.22%）（X^2=4.18 ,P〈0.05）. Conclusion Comprehensive nursing intervention has improvement on the declining of the postoperative cognitive function of patients treated with eider abdominal operation by general anesthesia, which can alleviate the declining of postoperative cognitive function of patients, and reduce the postoperative complication occurrence rate.