摘要
目的 :探讨老年结肠癌(COAD)患者腹腔镜术后发生认知功能障碍(POCD)的危险因素及干预策略。方法 :回顾性分析2017年1月~2022年1月于海安市中医院接受腹腔镜术治疗的200例老年COAD患者的临床资料,根据患者是否发生POCD将其分为POCD组(40例)和非POCD组(160例)。比较两组临床资料,将临床资料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COAD患者腹腔镜术后发生POCD的危险因素。结果 :POCD组年龄大于非POCD组;受教育年限短于非POCD组;麻醉时间长于非POCD;POCD组有高血压、糖尿病、术后第1 d视觉模拟评分(VAS)评分≥4分、术中出血量>1000 mL、术前未使用右美托咪啶、苏醒期躁动的患者占比均高于非POCD组。多因素Logistic回归分析结果显示,年龄大、麻醉时间长、有高血压、术后第1 d VAS评分≥4分、术中出血量>1000 mL、苏醒期躁动是老年COAD患者腹腔镜术后POCD风险的独立危险因素。结论 :老年COAD患者腹腔镜术后POCD风险的独立危险因素包括年龄大、麻醉时间长、有高血压、术后第1 d VAS评分≥4分、术中出血量>1 000 mL、苏醒期躁动等,对于伴有以上情况的患者,临床可针对性给予相应的治疗及预防,以降低术后POCD的风险。
Objective To investigate the risk factors and intervention strategies of postoperative cognitive dysfunction(POCD) in elderly patients with colon cancer(COAD) after laparoscopic operation. Methods The clinical data of 200 elderly patients with COAD who underwent laparoscopy in haian traditional chinese medicine hospital from January 2017 to January 2022 were retrospectively analyzed, and they were divided into the POCD group(40 cases) and the non POCD group(160 cases) according to whether the patients had POCD or not. The clinical data of the two groups were compared, and the statistically significant factors in clinical data were included in the multivariate analysis, and the risk factors of POCD risk in elderly patients with COAD after laparoscopic operation were analyzed by multivariate Logistic regression analysis. Results The age of the POCD group was older than that of the non POCD group;The length of schooling was shorter than that of the non POCD group;The duration of anesthesia was longer than that of the non POCD;The proportion of patients with hypertension, diabetes, the score of visual analogue score(VAS) ≥ 4 on the first day after operation, intraoperative bleeding >1 000 m L, dexmedetomidine was not used before surgery and restlessness in the awakening period in the POCD group were hihger than the POCD group. The results of multivariate Logistic regression analysis showed that old age, long anesthesia time, hypertension, the score of VAS≥ 4 on the first day after operation, intraoperative bleeding >1000 mL and restlessness in the awakening period were independent risk factors for POCD in elderly patients with COAD after laparoscopic operation. Conclusion The independent risk factors of POCD risk in elderly COAD patients after laparoscopic operation included old age, long anesthesia time, hypertension, the score of VAS≥ 4on the first day after operation, intraoperative bleeding >1 000 m L, restlessness during recovery, etc, for patients with the above conditions, corresponding treatment and pre
作者
顾玉洁
郑玉琳
刘时娟
Yujie Gu;Yulin Zheng;Shijuan Liu(Hai'an Hospital of Traditional Chinese Medicine,Nantong 226602,China)
出处
《湖南师范大学学报（医学版）》
2022年第5期118-121,共4页
Journal of Hunan Normal University(Medical Sciences)
基金
江苏省科研基金资助项目(Q202024510)。
