Dong Zhixia, Song Jie, Ge Minhua, Lin Chunyan, Zhang Jie, Chen Jie, Wu Yanmin
Department of Gastroenterology, the Affiliated Hospital of Jiangnan University, Wuxi, China.
Department of Hepatobiliary, the Affiliated Hospital of Jiangnan University, Wuxi, China.
Ann Palliat Med. 2020 Jul;9(4):2221-2228. doi: 10.21037/apm-20-913. Epub 2020 Jul 20.
Pancreatic encephalopathy is the most serious complication of severe acute pancreatitis (SAP) and substantially increases mortality. Delirium is a common clinical manifestation of pancreatic encephalopathy. This study aimed to assess the clinical effects of an improved version of the Hospital Elderly Life Program (HELP) on preventing delirium in elderly patients with SAP.
A total of 106 patients with SAP aged 70 years or older were randomly divided into an experimental group (53 cases) and a control group (53 cases). The experimental group was given 2 weeks of conventional nursing combined with the HELP regimen, while the control group was given 2 weeks of conventional nursing. Conventional nursing included disease care, geriatric syndrome care and observation of critically ill patients. The incidence of delirium, severity of delirium, self-care ability, cognitive function, length of hospital stay, and patient satisfaction were compared between the 2 groups before and after the intervention.
The incidence of delirium was 4.00% in the experimental group and 16.98% in the control group; the difference was statistically significant (P=0.033). After 2 weeks of intervention, the experimental group showed significantly better self-care ability and cognitive function, shorter hospital stay, and greater patient satisfaction than the control group (all P<0.05).
The improved HELP protocol for elderly patients with SAP can reduce the incidence and severity of delirium, improve self-care ability and cognitive function, shorten hospital stay, and increase patient satisfaction.
胰性脑病是重症急性胰腺炎（SAP）最严重的并发症，会显著增加死亡率。谵妄是胰性脑病常见的临床表现。本研究旨在评估改良版医院老年生活计划（HELP）对预防老年SAP患者谵妄的临床效果。
将106例年龄≥70岁的SAP患者随机分为试验组（53例）和对照组（53例）。试验组给予2周的常规护理并联合HELP方案，对照组给予2周的常规护理。常规护理包括疾病护理、老年综合征护理和重症患者观察。比较两组干预前后谵妄的发生率、谵妄严重程度、自我护理能力、认知功能、住院时间及患者满意度。
试验组谵妄发生率为4.00%，对照组为16.98%；差异有统计学意义（P = 0.033）。干预2周后，试验组的自我护理能力和认知功能明显优于对照组，住院时间更短，患者满意度更高（均P < 0.05）。
改良后的针对老年SAP患者的HELP方案可降低谵妄的发生率和严重程度，提高自我护理能力和认知功能，缩短住院时间，并提高患者满意度。
