摘要
目的研究影响全身麻醉老年下肢骨折患者术后认知功能障碍(POCD)发生的相关因素。方法选取2015年9月至2018年9月我院全身麻醉下行手术治疗的下肢骨折老年患者192例,根据术后7 d时简易智能精神状态检查量表(MMSE)评估患者认知水平,分为POCD组和正常组,比较两组临床资料,分析各因素对POCD的影响。结果192例患者均顺利完成手术,发生POCD 54例(28.13%);POCD组与正常组年龄、受教育年限、高血压病史、脑卒中病史、手术时间、术中平均动脉压(MAP)、术后感染发生率及术后自控镇痛应用情况比较,差异有统计学意义(P<0.05);Logistic回归分析结果显示受教育年限和术后自控镇痛为POCD保护因素,年龄、脑卒中病史及手术时间为全身麻醉高龄下肢骨折患者发生POCD的独立危险因素(P<0.05)。结论全身麻醉老年下肢骨折患者术后容易发生POCD,其主要影响因素包括年龄、受教育年限、脑卒中病史、手术时间及术后自控镇痛。
Objective To investigate the related factors affecting postoperative cognitive dysfunction (POCD) in elderly patients with lower extremity fractures after general anesthesia surgery.Methods A total of 192 elderly patients with lower extremity fractures who underwent surgery in our hospital from September 2015 to September 2018 were selected for the study.All patients were given surgery under general anesthesia.Mini-mental state examination (MMSE) was used to evaluate the cognitive level onthe 7th day after surgery,and the patients were divided into POCD group and normal group according to the results.The differences in clinical data were compared between the two groups,and logistic regression analysis was used to analyze the effects of various factors on POCD.Results All the 192 patients were successfully completed the surgery,and there were 54 cases of POCD,accounting for 28.13%.There were significant differences in age,years of education,history of hypertension,history of stroke,operative time,intraoperative MAP,incidence rate of postoperative infection and postoperative self-controlled analgesia applicationbetween the POCD group and the normal group ( P <0.05).Logistic regression analysis showed that years of education and postoperative self-controlled analgesia were protective factors for POCD,and age,history of stroke and operative time were independent risk factors for POCD ( P <0.05).Conclusion Elderly patients with lower extremity fractures after general anesthesia surgery are prone to POCD.The main influencing factors include age,years of education,history of stroke,operative time and postoperative self-controlled analgesia.
作者
王丽萍
季中华
任莉
WANG Li-ping;JI Zhong-hua;REN Li(Zhuhai People's Hospital,Zhuhai Hospital Affiliated with Jinan University,Zhuhai 519000,China)
出处
《实用医院临床杂志》
2020年第6期10-13,共4页
Practical Journal of Clinical Medicine
基金
广东省医学科研基金资助项目(编号:A2018541)。
关键词
下肢骨折
全身麻醉
认知功能障碍
影响因素
Lower extremity fractures
Elderly patients
General anesthesia
Cognitive dysfunction
Influencing factors
