摘要
目的:评价结直肠癌老年患者术后谵妄与术前修正衰弱指数(mFI)评分的关系。方法:收集全身麻醉下行结直肠癌手术的老年患者病历资料,性别不限,年龄65~90岁,原发肿瘤,术前未经过放疗、化疗的治疗措施,手术时间≥2 h。采用mFI量表评估患者术前衰弱状态。主要观察指标为术后7 d内谵妄发生率,采用意识错乱评估工具进行评估。收集患者术前基本资料、巴氏指数评分、mFI评分及简明智力状态检查量表评分;收集麻醉和手术相关信息、术中不良事件、术中液体总输入量、出血量和尿量。根据患者是否发生谵妄,分为谵妄组(D组)和非谵妄组(N组),采用logistic回归分析法筛选结直肠癌老年患者术后谵妄的危险因素。结果:共纳入370例患者,术后7 d内谵妄发生率为10.8%。与N组比较,D组患者年龄、ASA分级比例、mFI评分、麻醉时间和液体总入量差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示:mFI升高和年龄增加是术后谵妄发生的独立危险因素(P<0.05)。结论:mFI评分升高和年龄增加是结直肠癌老年患者术后谵妄发生的独立危险因素。
Objective To evaluate the relationship between postoperative delirium and preoperative modified frailty index(mFI)score in elderly patients undergoing colorectal cancer surgery.Methods The medical records of elderly patients of either sex,aged 65-90 yr,with primary tumor,without radiotherapy and chemotherapy before operation,with the expected operating time≥2 h,undergoing colorectal cancer surgery under general anesthesia,were collected.The patients′preoperative frailty was assessed using mFI scale.Primary outcome was the incidence of delirium within 7 days after operation,and delirium was assessed using Confusion Assessment Method.The preoperative baseline characteristics,BI score,mFI score and Mini-Mental State Examination were recorded;anesthesia-related information,surgery-related information,intraoperative adverse events,total volume of intraoperative fluid infused,blood loss,and urine output were recorded.The patients were divided into delirium group(D group)and non-delirium group(N group)according to whether delirium occurred or not,and logistic regression analysis was used to screen the risk factors for postoperative delirium in elderly patients with colorectal cancer.Results A total of 370 patients were enrolled in this study,and the incidence of delirium was 10.8%.There were significant differences in age,ASA grading ratio,mFI score,anesthetic time and total volume of intraoperative fluid infused between group N and group D(P<0.05).The results of multivariate logistic regression analysis showed that increased age and mFI were independent risk factors for the occurrence of postoperative delirium(P<0.05).Conclusions Increased mFI score and age are independent risk factors for postoperative delirium in elderly patients undergoing colorectal cancer.
作者
赵伟
张玥
韩亚娟
乔喜
赵召龙
张丹丹
贾慧群
Zhao Wei;Zhang Yue;Han Yajuan;Qiao Xi;Zhao Zhaolong;Zhang Dandan;Jia Huiqun(Department of Anesthesiology,Forth Hospital of Hebei Medical University,Shijiazhuang 050000,China;Department of Clinical Research Institute,Shenzhen PKU-HKUST Medical Center,Shenzhen 518000,China;Department of Anesthesiology,Shijiazhuang People′s Hospital,Shijiazhuang 050011,China)
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2022年第12期1437-1440,共4页
Chinese Journal of Anesthesiology
基金
河北省医学科学研究重点课题(20210755)。
关键词
结直肠肿瘤
老年人
谵妄
修正衰弱指数
Colorectal neoplasm
Aged
Delirium
Modified frailty index
