摘要
目的了解骨科手术患者发生术后认知功能障碍(Postoperative Cognitive Dysfunction,POCD)的影响因素及提出相应的护理对策。方法选择18例骨科手术术后发生POCD的患者作为病例组,另随机选取48例未发生POCD的骨科手术患者作为对照组。对各影响因素进行单因素比较和多因素Logistic回归分析。结果单因素分析显示,患者年龄、文化程度、术前是否合并糖尿病、麻醉方法在2组间差异均有统计学意义(P<0.05)。2组患者性别、吸烟指数、术前合并高血压及术中低血压差异均无统计学意义(P>0.05)。多因素Logistic回归分析显示,年龄和术前合并糖尿病与POCD的发生有关。结论高龄、术前合并糖尿病与POCD发生有关,对此类患者应预防POCD的发生并采取相应护理措施。
Objective To analyze influential factors associated with postoperative cognitive dysfunetion（POCD）in the patients undergoing orthopaedics surgery and provide nursing strategies. Methods 18 eases with POCD were reeuited as study group,and every case was matched with three controls. Multivariate non-conditional logistic regression were used to analyse the relationship between the exposure factors and POCD. Results The mean age of POCD group was significantly older than that of the control group （P〈0.05）. The relatively lower educational level,general anaesthesia and diabetes are the factors influencing the morbidity of POCD. The final regression model showed that age and diabetes before operation were significantly associated with POCD. Conclusions Age and diabetes before operation were closely associated with POCD in patients after orthopaedics surgery.
关键词
骨科手术
术后认知功能障碍
护理对策
Orthopaedics surgery
Postoperative cognitive dysfunction
Nursing strategies
