中国中西医结合急救杂志2026，Vol.33Issue(4)：445-449,5.DOI:10.3969/j.issn.1008-9691.2026.04.010
风险导向虚拟现实干预模式在重症医学科神经外科患者谵妄预防中的应用效果
The application of risk-oriented virtual reality intervention model in the prevention of delirium in neurosurgical intensive care unit
摘要
Abstract
Objective To establish a risk-oriented intervention system for delirium combined with virtual reality(VR)relaxation training,and explore its efficacy in delirium prevention among neurosurgical critically ill patients in the critical care medicine.Methods A total of 116 neurosurgical patients admitted to the department of critical care medicine of Guangdong Provincial People's Hospital,Guangdong Academy of Medical Sciences,Southern Medical University,from March 2025 to February 2026 were selected as the study subjects.The 58 neurosurgical critically ill patients admitted from March to August 2025 served as the control group and received the routine intensive care delirium prevention protocol.The 58 neurosurgical critically ill patients admitted from September 2025 to February 2026 served as the intervention group and received a combined intervention of risk-stratified tiered management plus VR relaxation training on the basis of the routine delirium prevention protocol.The incidence,duration,and severity of delirium assessed[memorial delirium assessment scale(MDAS)],as well as sleep quality assessed[Pittsburgh sleep quality index(PSQI)],pain evaluated[numerical rating scale(NRS)],anxiety[state-trait anxiety inventory-state subscale(STAI-S)],patient nursing satisfaction score[5-point Likert scale(Likert 5)],and the occurrence of adverse events were observed in both groups.Results Among the 116 patients included in the final analysis,the incidence of delirium in the intervention group was significantly lower than that in the control group[13.79%(8/58)vs.31.03%(18/58),P<0.05].The duration of delirium was significantly shorter in the intervention group than in the control group(hours:31.62±9.18 vs.48.31±11.46,P<0.05).The MDAS score(10.31±3.42 vs.15.55±4.11),PSQI score(6.05±2.00 vs.8.63±2.38),NRS score(2.28±1.03 vs.3.78±1.18),and STAI-S score(12.28±3.10 vs.16.78±3.48)were significantly lower in the intervention group than those in the control group(all P<0.05).The patient's nursing satisfaction score was significantly higher in the intervention group than that in the control group(4.40±0.51 vs.3.55±0.62,P<0.05).There was no statistically significant difference in the incidence of adverse events between intervention group and control group[10.34%(6/58)vs.13.79%(8/58),P>0.05].Conclusion Risk-oriented VR intervention can effectively prevent delirium,improve the physical and mental status of neurosurgical critically ill patients,with favorable safety profile;therefore,it is worthy of clinical promotion.关键词
风险导向/虚拟现实干预/神经外科重症患者/谵妄预防/非药物干预/重症监护护理Key words
Risk orientation/Virtual-reality intervention/Neurosurgical critically ill patients/Delirium prevention/Non-pharmacological intervention/Intensive care nursing引用本文复制引用
付霞,王华军,申叶林,陈苑亭,李碧惠..风险导向虚拟现实干预模式在重症医学科神经外科患者谵妄预防中的应用效果[J].中国中西医结合急救杂志,2026,33(4):445-449,5.基金项目
广东省医学科研基金(B2025436) Guangdong Medical Scientific Research Foundation(B2025436) （B2025436）
