摘要
目的探讨术前认知功能训练对心脏外科患者术后早期认知功能障碍(postoperative cognitive dysfunction,POCD)是否具有治疗作用。方法年龄50~70岁接受心脏外科手术的患者100例,随机分为对照组和训练组(n=50)。训练组患者在术前给予术前认知功能训练,对照组不训练。术前训练从术前5天开始(每天1次,每次60 min)。所有患者在手术当天、术后第3、5、7天接受简易智力状态检查量表(mini mental state examination,MMSE)和巴氏指数(Barthel index,BI)评估,评价患者认知功能和日常生活活动能力。结果 2组患者术前MMSE和BI评分无统计学差异(P>0.05);与对照组比较,训练组患者POCD的发生率显著降低(28%vs 16%,23%vs 12%,18%vs 8%P<0.05);训练组患者MMSE评分显著升高(MMSE:18.09±1.56) vs (22.99±2.32),(20.14±1.87) vs (23.08±2.11),(22.14±2.46) vs (24.65±3.06),P<0.05。另外,训练组患者术后3、5、7天BI评分高于对照组BI:(48.81±3.35) vs (54.29±4.06),(53.13±3.82) vs (67.74±5.14),(65.28±5.97) vs (74.23±6.38),P<0.05。结论术前认知功能训练可以改善心脏外科手术患者全麻术后认知功能、心理状态和提高自理能力。
Objective To explore whether the preoperative cognitive function training reduces the postoperative cognitive dysfunction in patients underwent the cardiac surgery. Methods One hundred patients aged 50~70 years old,undergoing cardiac surgery were randomly divided into control group and training group(n=50). The patients in training group were received preoperative cognitive function training(60 min for each time in each day) from preoperative 5 days. While the patients in control group were not received. All the patients were tested with the MMSE and BI to evaluate their cognitive function and daily activities pre-operation, 3 rd, 5 th and 7 th day after operation. Results There was no significant difference of geographic data, MMSE and BI between two groups(P>0.05). Compared with control group, the incidence of POCD in training group was significantly lower(28% vs 16%, 23% vs 12%, 18% vs 8%, P<0.05). Compared to control group, the MMSE and BI in training group at postoperative 3 rd, 5 th and 7 th day were significantly increased(MMSE: 18.09±1.56) vs(22.99±2.32),(20.14±1.87) vs(23.08±2.11),(22.14±2.46) vs(24.65±3.06), P<0.05;BI:(48.81±3.35) vs(54.29±4.06),(53.13±3.82) vs(67.74±5.14),(65.28±5.97) vs(74.23±6.38), P<0.05. Conclusion Preoperative cognitive function training significantly could reduce the incidence of POCD, improve the postoperative cognitive function and promote recovery of psychological status and quality of life in patients after cardiac operation.
作者
佟楠楠
杨安萍
TONG Nan-nan;YANG An-ping(Department of Dermatology,The Second Affiliated Hospital of Harbin Medical University,Harbin 150081,China)
出处
《哈尔滨医科大学学报》
CAS
2020年第2期215-217,F0003,共4页
Journal of Harbin Medical University
关键词
认知功能训练
老年患者
术后认知功能障碍
cognitive function training
postoperative cognitive dysfunction
cardiac surgery
