摘要
目的研究老年脊柱手术术后谵妄发生率及高危因素,为老年脊柱手术术后谵妄的预防提供理论依据。方法本研究观察对象为2015-06-2017-06于我院行脊柱手术的280例老年胸椎、颈椎、腰椎手术患者。将发生谵妄的患者设为观察组,未发生的患者设为对照组,通过单因素以及Logstic多因素回归分析判断老年脊柱手术术后谵妄的独立危险因素。结果 280例患者术后发生谵妄30例,发生率10.71%,谵妄出现平均时间(1.24±0.15)d;单因素分析显示两组年龄、手术时间、术中低氧血症、苏醒时间、术前焦虑、手术部位、术中低血压、术前睡眠障碍差异具有统计学意义(P<0.05);Logstic多因素回归分析显示年龄>70岁(OR=3.214,%95CI:1.121～7.675)、手术时间>150 min(OR=2.612,%95CI:1.721～9.623)、术前焦虑(OR=2.334,%95CI:1.021～10.421、术中低氧血症(OR=2.113,%95CI:1.733～7.316)、苏醒时间>60 min(OR=3.043,%95CI:1.421～11.232)是老年脊柱手术术后谵妄发生的独立危险因素。结论老年脊柱手术术后谵妄发生率较高,年龄>70岁、手术时间>150 min、术前有焦虑、术中出现低氧血症、苏醒时间>60 min均会增加术后谵妄的发生风险。
Objective To investigate the incidence rate and risk factors of delirium in elderlypatients after spinal surgery, and to provide a theoretical basis for the prevention of delirium afterspinal surgery. Methods In this study, 280 elderly patients underwent thoracic, cervical, lumbarsurgery in our hospital from June 2015 to June 2017 were selected. Patients with delirium wereincluded into observation group, and patients without delirium were included into control group. Singlefactor and Logistic multivariate regression analysis were used to determine the independent risk factorsof delirium after spine surgery. Results The incidence rate of delirium was 10.71% （30/280）, and itsaverage time was （1.24±0.15） d. Univariate analysis showed that the differences of age, operation time,intraoperative hypoxemia, recovery time, preoperative anxiety, operative site, intraoperativehypotension, preoperative sleep disorders were statistically significant （P〈0.05）. Logistic multivariateregression analysis showed that age 〉70 years （OR=3.214, 95% CI： 1.121-7.675）, operation time 〉150 minutes （OR=2.612, 95% CI：1.721-9.623）, preoperative anxiety （OR=2.334, 95% CI： 1.021-10.421）, intraoperative hypoxemia （OR=2.113, 95% CI：1.733 -7.316）, recovery time 〉 60 minutes（OR=3.043, 95% CI： 1.421 -11.232） were independent risk factors of delirium after spine surgery.Conclusion The incidence of delirium in elderly patients after spine surgery is relatively high.Moreover, the age 〉 70 years old, operation time 〉 150 minutes, preoperative anxiety, intraoperativehypoxemia, and recovery time 〉 60 min will increase the risk of postoperative delirium.
作者
李伟
罗江洪
LI Wei;LUO Jiang-hong(Department of Orthopedics,the Sixth People＇s Hospital of Chengdu,Chengdu,Sichuan,610051,China.)
出处
《颈腰痛杂志》
2018年第5期584-586,共3页
The Journal of Cervicodynia and Lumbodynia
