Application effect of enhanced recovery after surgery nursing on postoperative delirium and cognitive dysfunction in elderly patients with biliary tract
ZHANG Xiaodan WENG Linshu WU Beilei YU Haibo
Department of Hepatobiliary Surgery, Wenzhou Central Hospital, Zhejiang Province, Wenzhou 325000, China
Abstract：Objective To explore application effect of enhanced recovery after surgery （ERAS） nursing on postoperative delirium and cognitive dysfunction in elderly patients with biliary tract. Methods A total of sixty patients with biliary tract surgery admitted to the Department of Hepatobiliary Surgery of Wenzhou Central Hospital, Zhejiang Province from July 2022 to December 2022 were included, they were divided into control group and ERAS group by random number table method, with 30 cases in each group. The control group received general surgery basic nursing, ERAS group received ERAS mode nursing program on the basis of the control group. The incidence of postoperative delirium, cognitive function score, and postoperative adverse reactions were observed. Results After surgery, postoperative delirium incidence in ERAS group was lower than that in control group, and delirium duration in ERAS group was shorter than that in control group, and the differences were statistically significant (P＜0.05). The overall analysis showed that there were statistical significances in comparison between groups, comparison at time points and interaction of mini-mental state examination (MMSE) between the two groups (P＜0.05). Intra-group comparison showed that when the MMSE scores of the two groups were lower at 1, 3, and 7 days after surgery, the MMSE scores at 3 and 7 days after surgery were higher than those at 1 day after surgery, the MMSE scores at 1 and 3 months after surgery were higher than those at 3 days after surgery, and the MMSE scores at 1 and 3 months after surgery were higher than those at 7 days after surgery, the differences were statistically significant (P＜0.05). MMSE scores at 1, 3 and 7 days after operation in ERAS group were higher than those in control group, the differences were statistically significant (P＜0.05). The incidence of nausea and vomiting, urinary retention, sleep disorders and hypotension in ERAS group was lower than that in control group, and the duration of postoperative hospitalization was shorter, the differences were statistically significant (P＜0.05). Conclusion Compared with the conventional nursing scheme, the nursing ERAS can effectively reduce the occurrence of postoperative delirium, shorten the duration of delirium, reduce postoperative cognitive dysfunction and promote the recovery of cognitive function in elderly patients with biliary tract surgery, and is worthy of clinical promotion and application.
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2023, Vol. 20 
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