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围手术期心理教育干预可降低心脏手术后患者术后谵妄:一项初步研究。

Perioperative psycho-educational intervention can reduce postoperative delirium in patients after cardiac surgery: a pilot study.

机构信息

Department of Thoracic & Cardiovascular Surgery, Ajou University Medical Center, School of Medicine, Suwon, Korea.

出版信息

Int J Psychiatry Med. 2013;45(2):143-58. doi: 10.2190/PM.45.2.d.

Abstract

OBJECTIVE

Postoperative delirium after cardiac surgery is associated with many consequences such as poorer functional recovery, more frequent postoperative complications, higher mortality, increased length of hospital stay, and higher hospital costs. The aim of this study was to evaluate the efficacy of perioperative psycho-educational intervention in preventing postoperative delirium in post cardiac surgery patients.

METHOD

We conducted a comparative retrospective study between 49 patients who had received perioperative psycho-educational intervention and 46 patients who had received standard care. The primary outcome was the incidence of postoperative delirium. Secondary outcomes included length of ICU stay, and severity and duration of postoperative delirium among the patients who had developed delirium.

RESULTS

The incidence of postoperative delirium was significantly lower in the intervention group than that in the control group (12.24% vs. 34.78%, P = 0.009). Among the patients who had developed postoperative delirium, there was no statistical difference between the two groups regarding secondary outcomes.

CONCLUSIONS

Our results show that the patients who received perioperative psycho-educational intervention were associated with a lower incidence of postoperative delirium after cardiac surgery than those who received standard care. Clinicians would be able to implement this psycho-educational intervention as part of routine practice to reduce delirium.

摘要

目的

心脏手术后的术后谵妄与许多后果相关,如功能恢复较差、术后并发症更频繁、死亡率更高、住院时间延长和住院费用增加。本研究旨在评估围手术期心理教育干预预防心脏手术后患者术后谵妄的疗效。

方法

我们对 49 例接受围手术期心理教育干预的患者和 46 例接受标准护理的患者进行了比较回顾性研究。主要结局是术后谵妄的发生率。次要结局包括发生谵妄的患者 ICU 住院时间、谵妄的严重程度和持续时间。

结果

干预组术后谵妄的发生率明显低于对照组(12.24%比 34.78%,P = 0.009)。在发生术后谵妄的患者中,两组在次要结局方面无统计学差异。

结论

我们的结果表明,与接受标准护理的患者相比,接受围手术期心理教育干预的患者心脏手术后术后谵妄的发生率较低。临床医生可以将这种心理教育干预作为常规实践的一部分来减少谵妄。

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