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| Risk factors and strategies of acute consciousness disorder of elderly patients with hip fracture |
| GONG Jian LUO Cheng FENG Zhijie KONG Qinhai ZHANG Hongbin LIANG Junsheng |
| Department of Geriatric Orthopedics, the Second Hospital of Tangshan City, Hebei Province,Tangshan 063000, China |
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Abstract Objective To explore the risk factors of postoperative acute consciousness disorder of elderly patients with hip fracture and control measures. Methods Clinical data of 229 cases of elderly patients with hip fracture treated in the Second Hospital of Tangshan City from February 2014 to February 2017 were analyzed retrospectively. The incidence, clinical features and risk factors of postoperative acute conscious disturbance were analyzed, and then prevention and cure measures were discussed. Results Of 229 elderly patients with hip fracture, there were 62 cases of postoperative acute consciousness disorders, with the rate of 27.07%. Single factor analysis result showed that there were significant difference in age, postoperative infection, diabetes, adverse psychological factors, duration of anesthesia, mode of anesthesia, time of operation, intraoperative blood loss, postoperative pain score of postoperative acute consciousness disorders of elderly patients with hip fracture (P < 0.05). Multivariate Logistic analysis result showed that, age over 70 years, postoperative infection, diabetes, adverse psychological factors, anesthesia, intraoperative blood loss, postoperative pain scores were independent factors influencing the occurrence of acute consciousness disorders (OR=3.656, 1.857, 2.556, 2.031, 1.965, 2.062, 2.607, all P < 0.05). Conclusion The risk factors of acute consciousness disorders are age more than 70 years, postoperative infection, diabetes, adverse psychological factors, general intravenous anesthesia, intraoperative blood loss more and postoperative pain scores high. It should pay attention in clinical, and give intensive nursing, and strengthen perioperative care of elderly patients with hip fracture.
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[1] Roberts KC，Brox WT，Jevsevar D S，et al. Management of hip fractures in the elderly [J]. J Am Acad Orthop Surg，2015， 23（2）：131-137.
[2] 赵继芬.急性意识障碍的病种特征及诊断分析[J].临床急诊杂志，2016，17（2）：146-148.
[3] Krogseth M，Wyller TB，Engedal K，et al. Delirium is a risk factor for institutionalization and functional decline in older hip fracture patients[J]. J Psychosom Res，2014，76（1）：68-74.
[4] 胡维，周明全，谭祖键，等.高龄髋部骨折患者术后谵妄的高危因素分析[J].创伤外科杂志，2014，16（4）：324-327.
[5] 丁云云.骨科患者术后谵妄的预防和护理[J].基层医学论坛，2016，20（24）：3456-3457.
[6] Raats JW，van Eijsden WA，Crolla RM，et al. Risk Factors and Outcomes for Postoperative Delirium after Major Surgery in Elderly Patients[J]. PLoS One，2015，10（8）：e0136 071.
[7] 喻任，陆纯德，程艳，等.高龄髋部骨折患者术后谵妄危险因素调查[J].中国骨与关节损伤杂志，2016，31（4）：341-344.
[8] 孙丽萍，吴金球，张明月.老年髋部骨折患者术后谵妄护理进展[J].齐鲁护理杂志，2014，20（8）：48-51.
[9] 王利宏，徐国红，韦仙姣，等.骨科常见手术术后谵妄的危险因素分析[J].中华骨科杂志，2015，35（6）：650-655.
[10] 姚碧君.高龄髋部骨折患者术后认知功能障碍原因分析及护理[J].中国农村卫生事业管理，2013，33（6）：673-674.
[11] Grootven BV，Detroyer E，Devriendt E，et al. Is preoperative state anxiety a risk factor for postoperative delirium among elderly hip fracture patients? [J]. Geriatrics & Gerontology International，2016，16（8）：948.
[12] 贾佩玉，郭勇，王学敏，等.老年患者髋部骨折术后谵妄的危险因素分析[J].上海医学，2016，39（8）：477-481.
[13] 梁建萍，刘坚霞，刘友腥，等.老年患者髋关节置换术后发生意识障碍的相关因素及护理干预对策[J].白求恩医学杂志，2015，13（3）：327-328.
[14] 鲍宏玮，严力生，陈红梅，等.麻醉选择对老年人髋部骨折术后谵妄的影响[J].中国骨与关节损伤杂志，2016， 31（4）：393-394.
[15] Shanavas C，Basheer N，Alapatt J，et al. A Prospective Study on Hyponatremia in Traumatic Brain Injury [J]. Ijnt，2016，13（2）：94-100.
[16] 王伟，彭阁，张浩.关节置换术后早期意识障碍9例救治报道[J].中国医药指南，2016，14（22）：78-78.
[17] 朱国新，刘印华，李涓涓，等.急性意识障碍143例常见病因分析及治疗体会[J].医学信息，2016，29（6）：268-269.
[18] 高小雁.老年髋部骨折患者术后谵妄的危险因素及护理对策[J].中华老年骨科与康复电子杂志，2015，1（1）：59-61.
[19] 曹群英，秦星星.老年髋部骨折患者术后并发急性精神障碍的危险因素分析[J].护理管理杂志，2015，15（1）：19-20.
[20] 董云鹏，郑轩，吕朝晖，等.无痛病房对老年髋部骨折术后谵妄影响的研究[J].中国医学创新，2017，14（10）：29-32.
[21] 王瑞敏，张静.老年髋部骨折术后谵妄的预防及护理干预[J].河北中医，2014，36（12）：1892-1893.
[22] 刘莹，张世谦.连续舒适护理对老年髋部骨折术后患者的影响[J].中国医药导报，2016，13（8）：158-161. |
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