【摘要】 目的 探讨基于循证的综合护理干预方案在神经外科脑血管病患者术后谵妄管理中的应用效果。方法 选取2019年1月1日至2020年12月31日收治于复旦大学附属华山医院神经外科ICU的298例脑血管疾病术后患者作为研究对象，将其按照入院先后顺序分为对照组（n=149）与观察组（n=149）。对照组患者接受神经外科常规护理，观察组在此基础上接受基于循证方法制订的包含评估、预防与干预3个方面的综合护理干预。比较两组患者术后谵妄发生率、谵妄持续时间、神经功能减退发生率、ICU住院时长及术后住院时长。结果 观察组患者术后谵妄发生率、谵妄持续时间、神经功能减退发生率均低于对照组（均P<0.05）,ICU住院时长短于对照组（P<0.05）。结论循证综合护理干预方案能有效帮助脑血管疾病术后患者降低谵妄发生率、缩短谵妄持续时间和ICU住院时间，并可预防术后神经功能减退，对改善患者临床结局有积极意义。更多还原

【Abstract】 Objective To explore the effects of evidence-based comprehensive nursing intervention on the management of postoperative delirium in patients with cerebrovascular diseases in the neurosurgery department.Methods A total of 298 patients who had undergone surgeries for cerebrovascular diseases and were admitted to the Neurosurgical ICU of Huashan Hospital Affiliated to Fudan University from January 1, 2019 to December 31, 2020 were selected. They were divided into the control group(n=149)and the observation group(n=149) according to the order of their admission. The patients in the control group received routine neurosurgical nursing, while the patients in the observation group received evidence-based comprehensive nursing intervention involving evaluation, prevention and intervention.The incidence of postoperative delirium, duration of delirium, incidence of neurological dysfunction,length of ICU stay and length of postoperative hospital stay were compared between the two groups.Results The incidence of postoperative delirium, duration of delirium and incidence of neurological dysfunction in the observation group were lower/shorter than those in the control group(P<0.05 for all),and the length of ICU stay was shorter than that in the control group(P<0.05).Conclusion Evidencebased comprehensive nursing intervention has positive effects on improving the clinical outcomes of patients undergoing surgeries for cerebrovascular diseases, as it is effective to reduce the incidence of postoperative delirium, shorten the duration of delirium and length of ICU stay, and prevent postoperative dysfunction.更多还原