【摘要】 目的 探讨综合干预措施在围术期部分老年髋部骨折患者术后谵妄发生的应用效果。方法 收集2019年11月至2021年10月新疆维吾尔自治区人民医院骨科中心收治的65岁以上老年髋部骨折手术患者212例。入院后每日采用CAM法对患者进行评估，并将评估结果作为术后谵妄发生与结束的诊断依据。针对术后谵妄发生的高危因素制定综合干预措施。在常规治疗基础上进行综合干预，并根据CAM及DRS-R-98等方法进行评估，随时调整治疗方案。对老年髋部骨折患者术后的谵妄发生率、谵妄持续时间、谵妄严重程度、住院时间等进行记录及统计分析。结果 经综合干预后，干预组谵妄发生率为12.50%(14/112)，术后谵妄持续平均时间为（2.08±0.82）d，术后谵妄严重程度得分为（9.12±3.25）分，平均住院时间为(9.80±2.15)d，较对照组均有改善，差异有统计学意义。结论 综合干预措施在围手术期应用于老年髋部骨折患者，可有效降低老年患者围术期术后谵妄的发生率及严重程度，并能缩短患者的住院时间与谵妄持续时间。更多还原

【Abstract】 Objective To investigate the effect of comprehensive intervention measures on postoperative delirium in elderly patients with hip fracture during perioperative period. Methods A total of 212 patients over 65 years old with hip fracture surgery who were admitted to the Orthopaedic Center of the People′ s Hospital of Xinjiang Uygur Autonomous Region from November 2019 to October 2021 were collected. The patient was assessed daily after admission using the delirium assessment method and used as a basis for diagnosing the onset and end of postoperative delirium.Comprehensive intervention measures were developed to address the risk factors for postoperative delirium.Comprehensive intervention was carried out on the basis of conventional treatment,and evaluation was carried out according to CAM and DRS-R-98 methods,and the treatment plan could be adjusted at any time. The incidence of postoperative delirium,duration of delirium, severity of delirium and length of hospital stay were recorded and statistically analyzed. Results After comprehensive intervention, the incidence of delirium of the intervention group was12.50%(14/112);the average duration of postoperative delirium was(2.08±0.82)d;the severity score of postoperative delirium was(9.12±3.25)points; the average length of hospital stay was(9.80±2.15)d,which were improved compared with those in the control group, and the differences were statistically significant(P<0.05). Conclusion Comprehensive intervention measures in the perioperative treatment of elderly patients with hip fracture can effectively reduce the incidence and severity of postoperative delirium,and shorten the length of hospital stay and duration of delirium.更多还原