凌云志, 赵永娟, 赵佑君, 王刚. 围术期心理支持疗法对老年股骨颈骨折患者术后认知功能的影响[J]. 蚌埠医科大学学报, 2013, 37(5): 531-533.
    引用本文: 凌云志, 赵永娟, 赵佑君, 王刚. 围术期心理支持疗法对老年股骨颈骨折患者术后认知功能的影响[J]. 蚌埠医科大学学报, 2013, 37(5): 531-533.
    LING Yun-zhi, ZHAO Yong-juan, ZHAO You-jun, WANG Gang. Effect of perioperative psychological support therapy on cognitive function of elderly patient with femoral neck fracture[J]. Journal of Bengbu Medical University, 2013, 37(5): 531-533.
    Citation: LING Yun-zhi, ZHAO Yong-juan, ZHAO You-jun, WANG Gang. Effect of perioperative psychological support therapy on cognitive function of elderly patient with femoral neck fracture[J]. Journal of Bengbu Medical University, 2013, 37(5): 531-533.

    围术期心理支持疗法对老年股骨颈骨折患者术后认知功能的影响

    Effect of perioperative psychological support therapy on cognitive function of elderly patient with femoral neck fracture

    • 摘要: 目的:探讨实施围术期心理支持疗法对老年股骨颈骨折患者认知功能的影响。方法:选择34例全麻下行择期股骨颈骨折内固定术患者,随机分成围术期心理支持疗法(PPST组)和对照组,每组17例。术中监测血压、心率(HR)、脉搏氧饱和度、心电图;记录术毕、拔管时、拔管后5 min时的平均动脉压(MAP)和HR;记录患者麻醉前、术后3 h、6 h、1 d、3 d的简明精神状态量表(MMSE)评分,评价对其认知功能的影响。结果:2组患者拔管时、拔管后5 min的MAP和HR与术毕时比较均有升高(P0.01),但对照组升高的幅度均明显高于PPST组(P0.01)。PPST组MMSE评分在术后3 h时较麻醉前下降(P0.05),对照组MMSE评分在术后3 h、6 h、1 d时均较麻醉前明显下降(P0.01),2组在术后3 d时MMSE评分与麻醉前差异均无统计学意义(P0.05);对照组术后3 h、6 h、1 d时MMSE评分均低于PPST组(P0.05~P0.01)。结论:围术期心理支持疗法可降低老年股骨颈骨折患者术后认知功能障碍的发生率,提高拔管前后循环相对的稳定性,使患者平稳渡过围术期。

       

      Abstract: Objective: To investigate the effects of perioperative psychological support therapy on cognitive function of elderly patient with femoral neck fracture.Methods: Thirty-four cases with femoral neck fracture treated with internal fixation under general anesthesia were randomly divided into perioperative psychological support therapy group(PPST group) and control group(17 cases each group).The blood pressure(BP),heart rate(HR),pulse oxygen saturation and electrocardiography of two groups were observed during the operation.The mean artery pressure(MAP) and HR of two groups were recorded during extubation and at 5 minutes after extubation.mini-mental state examination(MMSE) scores of two groups were recorded before anesthesia and at 3,6,24 and 72 hours after operation,which was used to evaluate their cognitive function.Results: The levels of MAP and HR of two groups during extubation and at 5 minutes after extubation were higher than those after operation(P 0.01),but the increasing degree of control group was significantly higher than that in PPST group(P 0.01).Compared with preanesthesia,MMSE scores decreased significantly at 3 hours after operation in PPST group(P 0.01) and the control group decreased significantly at 3,6 and 24 hours after operation(P 0.01),the differeces of MMSE scores in two groups were not statistical significance at 72 hours after operation(P 0.05).MMSE scores of control group were lower than that in PPST group at 3,6 and 24 hours after operation(P 0.05 to P 0.01).Conclusions: Perioperative psychological support therapy can significantly reduce the incidence of postoperative cognitive dysfunction of elderly patient with femoral neck fracture and improve the relative stability of patients' circulation before and after the extubation,which keep patient stable during perioperative period.

       

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