谵妄,老年手术患者的常见并发症,围手术期护理面临重大挑战。围手术期老年服务(PGS)旨在管理合并症,术后并发症,并启动早期运动恢复,以提高围手术期老年患者的预后。研究表明,术前认知障碍患者术后谵妄的风险明显增加。虽然术后谵妄影响了高达70%的60岁以上的人和90%的神经退行性疾病患者,在许多情况下,它仍然未被诊断。术后谵妄可导致功能下降,住院时间延长,医疗费用增加,认知障碍,和心理不适。本文简要总结了关于谵妄的文献,其风险因素,以及围手术期的非药物管理策略。它强调了将认知和心理评估纳入围手术期护理方案以提供基线数据的重要性。改善患者预后,减少住院时间,减少与谵妄相关的并发症。通过采用基于证据的谵妄管理方案,医疗保健专业人员可以更好地识别和管理谵妄,最终提高老年手术患者的护理质量,这也将使医护人员和医疗机构受益。
Delirium, a common complication in elderly surgical patients, poses significant challenges in perioperative care. Perioperative geriatric services (PGS) aim at managing comorbidities, postoperative complications, and initiating early recovery of mobility to enhance elderly patients\' prognosis in the perioperative period. Studies have shown that patients with preoperative cognitive disorders are at a significantly increased risk of postoperative delirium. While postoperative delirium affects up to 70% of people over 60 and 90% of people with neurodegenerative diseases, it remains underdiagnosed in many cases. Postoperative delirium can lead to functional decline, prolonged hospitalization, increased healthcare costs, cognitive impairment, and psychological malaise. This article briefly summarizes the literature on delirium, its risk factors, and its non-pharmaceutical management strategies within the perioperative period. It highlights the importance of integrating cognitive and psychological assessments into perioperative care protocols to provide baseline data, improve patient outcomes, reduce hospital stays, and minimize complications associated with delirium. By embracing evidence-based delirium management protocols, healthcare professionals can better identify and manage delirium, ultimately improving the quality of care for elderly surgical patients, which would also benefit healthcare staff and healthcare institutions.