围术期疼痛干预对降低骨科老年病人术后精神障碍的影响1）

摘要

Obj ective:To probe into influence of perioperative pain in-tervention on reducing postoperative mental disorders in elderly or-thopedic patients.Methods:A total of 116 cases of patients aged 60 or older were selected as observation group from June 2010 to March 2012 in our department,aged 60 to 93 years old (70.07±8.18),and their pain was measured with pain intensity from 0 to 10 numeric scale(NRS).The pain intervention was given from the beginning to 3 days after admission of intervention,according to the pain score to adj ust analgesic medication and ensure the patients ’pain score at four points or less,and then to observe the incidence of mental disor-ders in patients.Conclusion:Postoperative reasonable analgesia can effectively reduce postoperative hypoxemia and nursing complications in elderly orthopedic patients,indirectly reduce the incidence of post-operative mental disorders and accelerate their postoperative rehabili-tation.%[目的]探讨围术期疼痛干预对降低骨科老年病人术后精神障碍的影响。[方法]选择116例60岁以上老年病人为观察组，疼痛使用0~10数字疼痛强度量表(NRS)法测量，从入院开始到术后3d内给予疼痛干预，根据痛觉评分调节镇痛用药，确保病人疼痛评分在4分以下，观察病人术后精神障碍发生率。[结果]观察组术后精神障碍发生率为7.76%，与本院2009年之前观察所得发生率为11.29%比较有明显降低；术后低氧血症：观察组为7例，发生率6.03%，对照组为9例，发生率14.52%，差异有统计学意义(P<0.05)；护理不良事件发生2例，与对照组对比，差异有统计学意义(P<0.05)。[结论]术后合理镇痛能有效降低骨科老年病人术后低氧血症及护理并发症，间接降低术后精神障碍的发生，加快术后康复。