关键词: 围手术期护理, 心理疗法, 认知障碍, 手术后并发症

Abstract: Objective To explore the impact of perioperative psychological support therapy on postoperative cognitive dysfunction in elderly patients with tuberculosis.Methods A case-control study was conducted.The elderly patients with tuberculosis who had undergone surgery during the period of July 2008 to May 2009(93 patients,control group) and of June 2009 to July 2010(91 patients,study group) were assessed by using the Mini-Mental State Examination(MMSE),Trail Making Test(TMT) Parts A & B,Digit Symbol Substitution Test(DSST),and Digit Span Test(DST) in Wechsler Adult Intelligence Scale-Revised by China(WAIS-RC),and Self-Rating Anxiety Scale(SAS).Results Seven days after surgery,the scores on TMT A were 49.96±10.43 in the control group and 44.02±17.29 in the study group(t=2.942,P<0.05),and those on TMT B were 67.99±17.72 and 60.37±18.88,respectively(t=2.971,P<0.05);the scores on DSST was 24.44±8.31 in the control group and 28.76±8.76 in the study group(t=3.578,P<0.01);the scores on MMSE was 26.47±2.07 in the control group and 27.62±2.73 in the study group(t=3.359,P<0.05);the scores on SAS was 35.33±7.12 in the control group and 30.51±5.10 in the study group(t=5.502,P<0.01).One month after surgery,the scores on TMT A were 44.49±10.89 in the control group and 37.61±13.49 in the study group(t=3.968,P<0.01),and those on TMT B were 61.64±15.35 and 54.00±16.49,respectively(t=3.392,P<0.05);the scores on DSST were 27.38±7.81 in the control group and 32.58±8.17 in the study group(t=4.602,P<0.01);the scores on DST were 7.71±1.33 in the control group and 8.81±1.36 in the study group(t=5.785,P<0.01);the scores on MMSE were 27.63±1.69 in the control group and 28.67±2.17 in the study group(t=3.785,P<0.01);the scores on SAS were 31.13±7.09 in the control group and 27.30±3.53 in the study group(t=4.836,P<0.01).Conclusion Perioperative psychological support therapy can effectively reduce the adverse effects of surgery on patients psychology and lower the degree of anxiety

Key words: Perioperative nursing, Psychotherapy, Cognition disorders, Postoperative complications