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老年患者术后谵妄的相关因素分析 被引量:16

Analysis of related factors of postoperative delirium in elderly patients
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摘要 目的探讨老年患者术后谵妄的相关影响因素,为其预防和治疗提供参考。方法手术后发生谵妄者54例为观察组,同期外科手术资料完整无谵妄者150例为对照组。比较分析2组年龄、性别、营养不良、水电解质紊乱、术后机械通气、术后低氧血症、重症感染以及术后疼痛程度和合并基础疾病的差异,二分类Logistic分析患者术后谵妄的影响因素。记录并分析观察组患者的疾病转归及预后情况。结果观察组平均年龄高于对照组,术后低氧血症、重症感染构成比例高于对照组(P<0.05)。高龄、术后有低氧血症、重症感染是患者术后发生谵妄的危险因素。观察组1例死于肺感染,1例死于多脏器功能衰竭,余52例患者出院3个月后均好转。结论高龄、术后有低氧血症、重症感染为患者术后谵妄发生的危险因素,临床术前与术后需要多加注意。 Objective To explore related influencing factors for postoperative delirium in elderly patients, to provide a reference for the prevention and treatment. Methods Fifty-four patients with delirium after surgery were used as observa?tion group, and a total of 150 subjects with no delirium after surgery during the same period were selected as the control group. Data of age, gender, malnutrition, disorders of water and electrolyte metabolism, postoperative mechanical ventilation, postoperative hypoxemia, severe infection and postoperative pain degree, and the combination of basic diseases were com?pared and analysed between two groups. The binary logistic regression analysis was used to analyse the influencing factors of postoperative delirium. The outcome and prognosis were observed and analyzed in observation group. Results The average age was significantly higher in observation group than that of control group (P<0.05). The percentages of postoperative hy?poxemia and severe infection were significantly higher in observation group than those of control group ( P<0.05). Patients with higher age, postoperative hypoxemia and severe infection were risk factors for postoperative delirium. In observation group,1 case died of lung infection, 1 case died of multiple organ failure, the remaining 52 patients were improved and dis?charged from hospital after three months. Conclusion For patients with higher age, postoperative hypoxemia and severe in?fection are the risk factors for occurrence of postoperative delirium. More attention should be paid to clinical preoperative and postoperative periods.
出处 《天津医药》 CAS 2016年第6期786-788,共3页 Tianjin Medical Journal
关键词 谵妄 手术后并发症 年龄因素 缺氧 感染 危险因素 delirium postoperative complications age factors anoxia infection risk factors
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  • 1Merkin A,Borisov I,Shushkevitch A,et al. Difficulties in diagnos-ing delirium in elderly patients in a general hospital[J]. Asian JPsychiatr,2014,9:85-86. doi:10.1016/j.ajp.2014.02.001.
  • 2Jildenst-l PK,Rawal N,Hallén JL,et al. Perioperative managementin order to minimise postoperative delirium and postoperative cogni-tive dysfunction:Results from a Swedish web- based survey[J].Ann Med Surg(Lond),2014,3(3):100-107. doi:10.1016/j.am-su.2014.07.001.
  • 3Kouros N. DSM-IV supervisor voices concerns about the diagnos-tic manual[J]. Monash Bioeth Rev,2013,31(2):16-17.
  • 4Whitlock EL,Vannucci A,Avidan MS. Postoperative delirium[J].Minerva Ainerva Anestesiol,2011,77(4):448-456.
  • 5Kratz T,Heinrich M,Schlau- E,et al. Preventing postoperative de-lirium:a prospective intervention with psychogeriatric liaison onsurgical wards in a general hospital[J]. Dtsch Arztebl Int,2015,112(17):289-296. doi:10.3238/arztebl.2015.0289.
  • 6商苏杭,屈秋民.高血压与认知功能障碍[J].中国现代神经疾病杂志,2015,15(8):615-622. 被引量:15
  • 7Capri M,Yani SL,Chattat R,et al. Pre-operative,high-il-6 blood levelis a risk factor of post-operative delirium onset in old patients[J]. FrontEndocrinol(Lausanne),2014,5:173. doi:10.3389/fendo.2014.00173.
  • 8Ratts JW,van Eijsden WA,Crolla RM,et al. Risk factors and out-comes for postoperative delirium after major surgery in elderly pa-tients[J]. PLoS One,2015,10(8):e0136071. doi:10.1371/journal.pone.0136071.
  • 9李雅巍,王东信.炎症反应与术后认知功能并发症的关系研究进展[J].解放军医学杂志,2014,39(8):673-677. 被引量:20
  • 10Lepousé C,Lautner CA,Liu L,et al. Emergence delirium inadults in the post-anaesthesia care unit[J]. Br J Anaesth ,2006,96(6):747-753.

二级参考文献93

  • 1陈宏,洪华山.高血压血管重构及高血压状态下的颈动脉血管重构[J].中国组织工程研究与临床康复,2007,11(14):2724-2728. 被引量:16
  • 2Gorelick PB, Scuteri A, Black SE, Decarli C, Greenberg SM, Iadecola C, Launer LJ, Laurent S, Lopez OL, Nyenhuis D, Petersen RC, Schneider JA, Tzourio C, Arnett DK, Bennett DA, Chui HC, Higashida RT, Lindquist R, Nilsson PM, Roman GC, Sellke FW, Seshadri S; American Heart" Association Stroke Council; Council on Epidemiology and Prevention; Council on Cardiovascular Nursing; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Surgery and Anesthesia. Vascular contributions to cognitive impairment and dementia a statement for heahhcare professionals from the American Heart Association/American Stroke Association. Stroke, 2011, 42:2672-2713.
  • 3Skoog I, Gustafson D. Update on hypertension and Alzheimer's disease. Neurosci Res, 2006, 28:605-611.
  • 4Elias MF, Goodell AL, Dore GA. Hypertension and cognitive functioning: a perspective in historical context. Hypertension, 2012, 60:260-268.
  • 5Kfihler S, Baars MA, Spauwen P, Schievink S, Verhey FR, van Boxtel MJ. Temporal evolution of cognitive changes in incident hypertension prospective cohort study across the adult age span. Hypertension, 2014, 63:245-251.
  • 6Poggesi A, Pantoni L, Inzitari D, Fazekas F, Ferro J, O'Brien J, Hennerici M, Schehens P, Erkinjuntti T, isser M, Langhorne P, Chabriat H, Waldemar G, Wallin A, Wahlund A; LADIS Study Group. 2001-2011, a decade of the LADIS (Leukoaraiosis And DISability) Study: what have we learned about white matter changes and small - vessel disease? Cerebrovasc Dis, 2011, 32:577-588.
  • 7Goldstein FC, Levey AI, Steenland NK. High blood pressure and cognitive decline in mild cognitive impairment. J Am Geriatr Soc, 2013, 61:67-73.
  • 8Wysocki M, Luo X, Schmeidler J, Dahlmar: K, Lesser GT, Grossman H, Haroutunian V, Beeri MS. Hypertension is associated with cognitive decline in elderly people at high risk for dementia. Am J Geriatr Psychiatry 2012, 20:179-187.
  • 9Joas E, Backman K, Gustafson D, Ostling S, Waern M, Guo X, Skoog I. Blood pressure trajectories from midlife to late life in relation to dementia in women followed for 37 years. Hypertension, 2012, 59:796-801.
  • 10Ninomiya T, Ohara T, Hirakawa Y, Yoshida D, Doi Y, Hata J, Kanba S, Iwaki T, Kiyohara Y. Midlife and late-life blood pressure and dementia in Japanese elderly: the Hisayama study. Hypertension, 2011, 58:22-28.

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