摘要
目的探讨心内直视术后早期认知功能障碍(POCD)的危险因素。方法心内直视术后315例患者,分别在术前7 d和术后7 d采用中文版简易精神状态检查量表(MMSE)进行认知功能评价,按是否发生POCD,将患者分为POCD组和非POCD组。收集两组患者性别、年龄和体质指数等共26个相关因素,通过单因素分析和多因素logistic回归分析筛选心内直视术后发生早期POCD的独立危险因素。结果 315例患者中有301例完成本研究,其中发生POCD 138例(45.8%)。单因素分析显示,年龄、受教育程度、吸烟、饮酒、高血压、冠心病、糖尿病、脑血管病、药物依赖、阿托品用量、体外循环时间、手术时间、术中低血压和术后疼痛在两组间差异有统计学意义(P均<0.05)。多因素logistic回归分析显示:年龄、吸烟、饮酒、高血压、糖尿病、阿托品用量、体外循环时间和术中低血压是心内直视术后发生早期POCD的独立危险因素(P均<0.05),受教育程度是其保护因素。结论 POCD是心内直视术后常见的并发症。年龄、吸烟、饮酒、高血压、糖尿病、阿托品用量、体外循环时间和术中低血压是术后发生早期POCD的危险因素,受教育程度是其保护因素。
Objective To investigate the risk factors of early postoperative cognitive dysfunction （POCD） in patients after open heart surgery. Methods A total of 315 patients undergoing open heart surgery were divided into POCD group and non-POCD group by the mini-mental state examination（MMSE） 7 days before and after operation, respectively. The gender,age,body mass index and other 23 related factors were collected from both groups. The independent risk factors of early POCD after open heart surgery were determined by univariate and multivariate logistic regression analysis. Results Of 301 patients who completed the study,138（45.8% ） cases developed POCD. Univariate analysis showed that age,level of education, smoking, drinking, hypertension, coronary heart disease, diabetes, cerebrovascular disease, drug dependence, dosage of atropine, time of cardiopulmonary bypass, time of operation, intra-operative hypotension and postoperative pain were significantly different between two groups（ P 〈 0.05 ）. Multivariate logistic regression analysis suggested that age, smoking, drinking,hypertension, diabetes, dosage of atropine, time of cardiopulmonary bypass and intra-operative hypotension were the independent risk factors associated with early POCD in patients after open heart surgery（ all P 〈 0.05） ,level of education was the protective factor. Conclusion POCD is a common complication after open heart surgery. Age,smoking, drinking, hypertension, diabetes, dosage of atropine, time of cardiopulmonary bypass and intra-operative hypotension are the independent risk factors associated with early POCD in patients after open heart surgery, and level of educational is a protective factor of POCD.
出处
《广西医学》
CAS
2013年第3期292-297,共6页
Guangxi Medical Journal
基金
广西卫生厅科研立项课题(Z2012109)
