Perioperative delirium in the elderly with hip fracture / 中华老年医学杂志

Objective To assess the influencing factors of perioperativc delirium in the elderly with hip fracture and to define strategies for prevention and management. Methods DSM-Ⅳ was adopted to diagnosis of perioperative delirium in the elderly with hip fracture, The data of 148 elderly patients with hip fracture were analyzed retrospectively and classified according to the clinical characteristics. The differences were analyzed statistically between the delirious group and the control group. Results There were 26 (17.6%) cases diagnosed with delirium in the perioperative period, including 22 cases with postoperative delirium, and the delirious symptom lasted 3 days in average. For the type of delirium, there were 15 cases with mania type, 4 cases with inhibitory type and 7 cases with mixed type. Compared with patients in control group, patients with perioperative delirium were older [(79.67±7.7) years old vs. (75.5±7.0)years old, t=2.668, P=0.008)]. Five cases who had previous delirium occurred perioperative delirium, and five patients who received external fixator showed no perioperative delirium. Conclusions Perioperative delirium is a heterogeneous symptom on the basis of brain aging and degeneration. It affects the prognosis of the elderly patients with hip fracture and should be viewed as a separate entity, which can be prevented and treated through comprehensive management.

Observation and nursing with different intravenous depressors for perioperative hypertension in Intensive Care Unit / 中国康复理论与实践

@# ObjectiveTo observed the clinical result of 3 kinds of commonly used depressor in Intensive Care Unit (ICU) and attend to the main point in nursing.MethodsNitroglycerin, sodium nitroprosside and urapidil hiydrochloride were used among 60 patients with perioperative hypertension in ICU respectively.ResultsSodium nitroprosside showed obviously depressed result, but needs to be observed tightly. Nitroglycerin and urapidil hiydrochloride depressed the blood pressure gentlely, and were suitable to old people particularly.ConclusionThe nurse can carry on corresponding clinical observation and nursing according to the pharmacology function of 3 kinds of medicines.