摘要
目的探讨老年患者髋关节置换术后谵妄的发生现状及其相关影响因素。方法回顾性分析200例接受髋关节置换术治疗的老年患者临床资料,根据髋关节置换术后谵妄发生情况分为谵妄组(45例)与非谵妄组(155例)。统计老年患者髋关节置换术后谵妄的发生现状,比较2组的临床资料,将其中有统计学意义的因素纳入多因素分析,并予以多因素Logistic回归分析法分析老年患者髋关节置换术后谵妄的危险因素。结果200例老年患者髋关节置换术后发生谵妄45例,术后谵妄发生率为22.50%。谵妄组年龄、美国麻醉师协会评分(ASA)评分、术后血清C-反应蛋白(CRP)水平及疾病类型为股骨颈骨折、合并慢性阻塞性肺疾病、伴有睡眠障碍、伴有认知障碍、伴有营养障碍的患者占比均高于非谵妄组(P<0.05),术后全血血红蛋白(Hb)、术后全血红细胞比容均低于非谵妄组(P<0.05)。多因素Logistic回归分析结果显示,年龄高、疾病类型为股骨颈骨折、合并慢性阻塞性肺疾病、ASA评分高、术后血清CRP水平高是老年患者髋关节置换术后谵妄的危险因素(OR=4.104;3.943;3.777;3.702;3.695,P<0.05)。结论老年患者髋关节置换术后谵妄的发生率较高,年龄高、疾病类型为股骨颈骨折、合并慢性阻塞性肺疾病、ASA评分高、术后血清CRP水平高等是老年患者髋关节置换术后谵妄发生的危险因素。
Objective To investigate the current status and related influencing factors of delirium in elderly patients after hip arthroplasty.Methods The clinical data of 200 elderly patients who underwent hip replacement at Yuncheng Hospital of Traditional Chinese Medicine from February 2019 to February 2021 were retrospectively analyzed,and they were divided into the delirium group(45 cases)and the non-delirium group(155 cases)based on whether the selected patients had delirium after the operation.The incidence of delirium in elderly patients after hip replacement was counted,and the clinical data of the two groups were compared,with the statistically significant factors included in the multivariate analysis and the risk factors of delirium analyzed by the multivariate Logistic regression analysis.Results A total of 45 of 200 elderly patients developed delirium after hip replacement,and the incidence of delirium was 22.50%.The age,ASA score,level of postoperative serum C-reactive protein(CRP)and proportion of the disease type of femoral neck fracture complicated with chronic obstructive pulmonary disease,sleep disorder,cognitive disorder and nutritional disorder in the delirium group were higher than those in the non-delirium group(P<0.05),while the postoperative total hemoglobin(Hb)and postoperative total hematocrit were lower than those of the non-delirium group(P<0.05).The results of the multivariate Logistic regression analysis showed that the higher age,femoral neck fracture,chronic obstructive pulmonary disease,high ASA score,and high postoperative serum CRP level were the risk factors for delirium in elderly patients after hip replacement(OR=4.104;3.943;3.777;3.702;3.695,P<0.05).Conclusion The incidence of delirium in elderly patients after hip replacement is higher,with the higher age,disease type of femoral neck fracture combined with chronic obstructive pulmonary disease,high ASA score,and high postoperative serum CRP level as the main risk factors of the disease.
作者
张宏
李淑萍
ZHANG Hong;LI Shuping(Departinent of Anesthesiology,Yuncheng Hospital of Traditional Chinese Medicine,Yuncheng 044000,China)
出处
《长春中医药大学学报》
2022年第10期1155-1159,共5页
Journal of Changchun University of Chinese Medicine
基金
国家卫生健康委“十四五”规划全国重点课题(YYWS3149)。
关键词
髋关节置换术
老年
谵妄
影响因素
hip replacement
elderly
delirium
influencing factors
