摘要
目的探讨老年脊柱结核(STB)患者术后发生认知功能障碍(POCD)的危险因素及干预对策。方法选取2020年10月至2023年2月新乡医学院第一附属医院收治的老年STB患者共计80例,统计术后POCD发生情况,进行单因素分析与多因素Logistic回归分析以明确老年STB患者术后发生POCD的危险因素。结果80例老年STB患者中16例术后发生POCD,发生率为20.00%(16/80);POCD组初中及以下文化程度、住院时间≥10 d、术后第1 d视觉模拟评分法(VAS)评分≥4分、糖尿病、术中最低局部脑氧饱和度(rSO_(2))<60%、rSO_(2)低于60%持续时间>30 min患者占比较非POCD组更高,差异有统计学意义(P<0.05);多因素Logistic分析结果发现,初中及以下文化程度(OR=1.895)、住院时间≥10 d(OR=2.513)、术后第1 d VAS评分≥4分(OR=2.376)、糖尿病(OR=1.968)、术中最低rSO_(2)<60%(OR=4.205)、rSO_(2)低于60%持续时间>30 min(OR=5.031)是影响老年STB患者发生POCD的独立危险因素,差异有统计学意义(P<0.05)。结论文化程度、住院时间、术后第1天VAS评分、糖尿病、术中最低rSO_(2)、rSO_(2)低于60%持续时间等均与引发老年STB患者术后发生POCD存在密切关系,临床应实施专业的干预对策,以减少POCD发生。
Objective To explore the risk factors and intervention strategies for postoperative cognitive dysfunction(POCD)in elderly patients with spinal tuberculosis(STB).Methods A total of 80 elderly STB patients who were admitted in the First Affiliated Hospital of Xinxiang Medical College from October 2020 to February 2023 were selected.The incidence of postoperative POCD was statistically analyzed,and univariate analysis and multivariate logistic regression analysis were conducted to identify the risk factors for postoperative POCD in elderly STB patients.Results Among the 80 elderly STB patients,16 experienced postoperative POCD,with incidence rate was 20.00%(16/80).Compared with the non POCD group,the proportion of education level in junior high school and below,hospital stay≥10 days,visual analogue scale(VAS)score≥4 points at 1 day after surgery,diabetes,lowest intraoperative regional cerebral oxygen saturation(rSO_(2))<60%,and rSO_(2)<60%for more than 30 minutes in the POCD group was higher,with a statistically significant difference(P<0.05).Logistic multifactor analysis showed that education level of junior high school and below(OR=1.895),length of stay≥10 d(OR=2.513),VAS score≥4 at 1 day after surgery(OR=2.376),diabetes(OR=1.968),lowest rSO_(2)<60%(OR=4.205)during surgery,and duration of rSO_(2) below 60%>30 min(OR=5.031)were independent risk factors for POCD in elderly STB patients,with a statistically significant difference(P<0.05).Conclusion Education level,length of stay,VAS score at 1 day after surgery,diabetes,the lowest rSO_(2) during operation,and the duration of rSO_(2) below 60%are closely related to POCD in elderly STB patients after operation.Professional intervention measures should be implemented in clinical practice to reduce POCD.
作者
李营
许庆宝
佑路标
LI Ying;XU Qingbao;YOU Lubiao(Fifth wards of orthopedic surgery,First Affiliated Hospital of Xinxiang Medical College,Xinxiang Henan 453000,China)
出处
《临床研究》
2024年第6期158-161,共4页
Clinical Research
关键词
老年脊柱结核
认知功能障碍
危险因素
干预对策
elderly spinal tuberculosis
cognitive impairment
risk factors
intervention strategies
