摘 要
老年髋部骨折患者术后谵妄发生率较高，严重影响患者康复进程及预后。本研究旨在探讨有效的预防与护理干预措施以降低术后谵妄发生率。基于此背景，本研究选取某三甲医院2019年1月至2022年1月收治的老年髋部骨折术后患者300例作为研究对象，采用随机数字表法分为观察组和对照组各150例，对照组给予常规护理，观察组在常规护理基础上实施综合性护理干预，包括术前心理评估与干预、优化病房环境、早期活动指导、疼痛管理等。经统计分析发现，观察组术后谵妄发生率为8.0%，明显低于对照组的22.0%，差异有统计学意义（P0.05）。同时，观察组患者住院时间较对照组缩短，家属满意度更高。本研究创新性地构建了涵盖多方面因素的综合性护理干预模式，强调个体化护理方案制定，从生理 - 心理 - 社会多维度出发，为老年髋部骨折患者术后谵妄的预防提供了新思路，有助于提高患者术后生活质量，减轻家庭和社会负担，对临床护理工作具有重要指导意义。
关键词：老年髋部骨折；术后谵妄；综合性护理干预；预防措施；患者康复
Abstract
Postoperative delirium in elderly patients with hip fractures is prevalent and significantly affects the rehabilitation process and prognosis. This study aims to investigate effective preventive and nursing interventions to reduce the incidence of postoperative delirium. A total of 300 elderly patients who underwent hip fracture surgery at a tertiary hospital between January 2019 and January 2022 were selected as subjects and divided into observation and control groups of 150 patients each using a random number table method. The control group received routine care, while the observation group was provided with comprehensive nursing interventions based on routine care, including preoperative psychological assessment and intervention, optimization of the ward environment, early mobilization guidance, and pain management. Statistical analysis revealed that the incidence of postoperative delirium in the observation group was 8.0%, significantly lower than the 22.0% in the control group (P0.05). Additionally, patients in the observation group had shorter hospital stays and higher family satisfaction. This study innovatively constructed a comprehensive nursing intervention model encompassing multiple factors, emphasizing the formulation of individualized care plans from physiological, psychological, and social dimensions, providing new insights for preventing postoperative delirium in elderly hip fracture patients, improving postoperative quality of life, and alleviating the burden on families and society, which holds significant implications for clinical nursing practice.
Keywords：Geriatric Hip Fracture；Postoperative Delirium；Comprehensive Nursing Intervention；Preventive Measures；Patient Rehabilitation
目 录
摘 要 I
Abstract II
引 言 1
第一章 谵妄的发病机制与风险因素 2
1.1 老年髋部骨折术后特点 2
1.2 谵妄发生的主要机制 2
1.3 高危因素识别与评估 3
第二章 术前预防措施的构建 5
2.1 患者全面评估体系 5
2.2 优化术前准备流程 5
2.3 心理支持与家属沟通 6
第三章 术后护理干预策略 7
3.1 环境管理与安全防护 7
3.2 生命体征监测要点 7
3.3 多学科协作护理模式 8
第四章 综合性预防与干预效果 9
4.1 干预措施依从性分析 9
4.2 谵妄发生率统计评价 9
4.3 护理质量持续改进方案 10
结 论 12
参考文献 13
致 谢 14
