Li Xueping, Zheng Miaomiao, Lin Ailin, Chen Chaohong, Wu Yuanbo, Zhang Huai, Yin Zhiqin
Department of Cardiac Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, People's Republic of China.
Wenzhou Medical University School of Nursing, Wenzhou, 325000, People's Republic of China.
Perioper Med (Lond). 2025 Feb 3;14(1):13. doi: 10.1186/s13741-025-00495-y.
Postoperative delirium is a common and significant consequence in patients with type A aortic dissection following surgery; however, there is currently no effective postoperative care plan.
The purpose of this study is to develop and evaluate the practical implementation of a stratified nursing intervention program for postoperative delirium in patients undergoing surgery for Stanford type A aortic dissection.
A stratified nursing intervention program for postoperative delirium was created using a literature review, group discussions, and the Delphi method via expert mail inquiry. A quasi-experimental design was used, with patients admitted to the general ward of a tertiary hospital in Wenzhou, China, functioning as subjects. From September to December 2022, 43 patients were included in the control group and given standard treatment. From January to June 2023, 37 patients were recruited in the intervention group, receiving both routine care and the intervention plan. The intervention's effects were compared in the two groups.
The intervention group had considerably shorter delirium and hospital stays than the control group (P < 0.05), as well as higher patient satisfaction levels. There were no inadvertent extubations in the intervention group. When the incidence and beginning time of delirium in the general ward were compared, there were no significant differences between the two groups (P > 0.05).
Implementing this nurse intervention in the ward context can shorten postoperative delirium and hospital stays, increase patient satisfaction with care, and improve patient prognosis and quality of life. This intervention will also serve as a great resource for future clinical management of postoperative delirium.
The National Health Security Information Platform's Medical Research Registration Information System has registered this study under the registration number MR-33-22-022978.
术后谵妄是A型主动脉夹层患者术后常见且严重的后果；然而，目前尚无有效的术后护理方案。
本研究旨在制定并评估一项针对斯坦福A型主动脉夹层手术患者术后谵妄的分层护理干预方案的实际实施效果。
通过文献回顾、小组讨论以及专家函询的德尔菲法，制定了一项针对术后谵妄的分层护理干预方案。采用准实验设计，选取中国温州某三级医院普通病房收治的患者作为研究对象。2022年9月至12月，43例患者纳入对照组，给予标准治疗。2023年1月至6月，37例患者纳入干预组，接受常规护理和干预方案。比较两组干预效果。
干预组的谵妄持续时间和住院时间明显短于对照组（P＜0.05），患者满意度也更高。干预组未发生意外拔管情况。比较普通病房谵妄的发生率和开始时间，两组之间无显著差异（P＞0.05）。
在病房环境中实施该护理干预可缩短术后谵妄持续时间和住院时间，提高患者对护理的满意度，改善患者预后和生活质量。该干预措施也将为未来术后谵妄的临床管理提供重要参考。
本研究已在中国国家医保信息平台医学研究登记信息系统注册，注册号为MR-33-22-022978。
