摘要
目的 探讨认知储备(CR)对苏醒期谵妄(ED)的影响,以期为ED的预防和预测提供参考。方法 选择2021年5-8月西南医科大学附属医院普外科择期全麻手术患者220例,术前收集患者CR参数,根据CR得分,按中位数水平(156.5分)分为高认知储备组(n=110)和低认知储备组(n=110);使用ICU意识模糊评估量表(CAM-ICU)进行谵妄评估;采用倾向性得分匹配(PSM)控制两组混杂因素后比较两组ED发生情况,并使用二元logistic回归分析CR对ED的影响。结果 PSM后匹配192例样本数据,共40例(20.8%)发生ED,高认知储备组有7例(7.3%),低认知储备组有33例(34.4%),组间比较,差异有统计学意义(P<0.05)。二元logistic回归分析表明ED风险随着CR(OR=0.951,P<0.05)的增高而减少;随着年龄(OR=1.063,P<0.05)和手术时间(OR=1.007,P<0.05)的增加而增加。结论 CR为ED的保护因素,高CR个体ED发生率低于低CR个体,CR为ED的预防和预测提供了新思路。
Objective To investigate the effect of cognitive reserve(CR) on the emergency delirium(ED) in order to provide reference for the prevention and prediction of ED.Methods A total of 220 patients undergoing elective general anesthesia operation in the general surgery department of this hospital from May to August 2021 were selected.The patients′ CR parameters were preoperatively colleted.The patients were divided into the high CR group(n=110) and low CR group(n=110) according to the median level(156.5 points) of CR score;delirium was assessed by the CAM-ICU scale;the propensity score matching(PSM) was used to control the confounding factors in the two groups and the occurrence of ED was compared between the two groups.And the effect of CR on ED was analyzed by the binary logistic regression.Results After PSM,the data of 192 samples were matched, 40 cases(20.8%) developed ED,7 cases(7.3%) in the high CR group, 33 cases(34.4%) in the low CR group, and the difference between the groups was statistically significant(P<0.05).The binary logistic regression analysis showed that the risk of ED was decreased with the CR increase(OR=0.951,P<0.05);and which was increased with the increase of age(OR=1.063,P<0.05) and operative time(OR=1.007,P<0.05).Conclusion CR is a protective factor of ED.The incidence rate of ED in the individuals with high CR is lower than that in the individuals with low CR.CR provides a new idea for the prevention and prediction of ED.
作者
汤灵宇
陈顺利
陈琪
郑思琳
TANG Lingyu;CHEN Shunli;CHEN Qi;ZHENG Silin(Affiliated Hospital of Southwest Medical University,Luzhou,Sichuan 646000,China;College of Nursing,Southwest Medical University,Luzhou,Sichuan 646000,China)
出处
《现代医药卫生》
2023年第1期6-11,共6页
Journal of Modern Medicine & Health
基金
四川省卫生和计划生育委员会科研课题(17PJ314)。
关键词
认知储备
苏醒期谵妄
谵妄
认知能力
Cognitive reserve
Emergency delirium
Delirium
Cognitive ability
