:Study of patients undrergoing gastric and colorectal operations
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概要
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Nineteen patients over the age of 80 undergoing surgery, ten for gastric cancer and nine for colorectal cancer, were studied to analyze the etiology of postoperative delirium in elderly patients, and to elucidate appropriate preventative nursing care.<BR>Postoperative delirium occurred in 7 out of the 19 (37%). These ("A group") were evaluated comparatively with the other 12 ("B group") in order to investigate the background factors. Regarding operative procedure, the incidence rate of delirium was 66% (6/9) in patients with colorectal cancer, and 10% (1/10) in patients with gastric cancer: significantly higher in the former (p=0.0198). However, A and B groups showed no difference in preoperative Hb, vital capacity, blood loss and the postoperative value of serum Na. Further investigation with more cases might be recommended in these points. Regarding the postoperative course of care, the first flatus was 5±1 days in A group, and 4±1 days in B group, the former significantly later than the latter (p=0.0064). The first bowel movement also tended to be later in A group. Preoperative long starvation seemed to be associated with postoperative delirium, since all of the three patients who had colorectal stenosis requiring total parental nutrition underwent delirium. The following two points should also be given sufficient consideration during nursing in addition to the various guidelines on preventative measures for postoperative delirium in patients over the age of 80. 1) In aged patients who suffer from ileus due to colorectal cancer necessitating preoperative fasting and IVH treatment, particular effort should be made with prevention and early detection and treatment. 2) Postoperative recovery of bowel movement is delayed in patients with postoperative delirium, so sufficient nursing assistance with position change and early ambulation should be given.
- 特定非営利活動法人 日本医療マネジメント学会の論文
特定非営利活動法人 日本医療マネジメント学会 | 論文
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