摘要
目的:分析Stanford A型主动脉夹层(ATAD)患者术后发生谵妄的影响因素。方法:回顾性分析2020年1月至2023年12月该院收治的176例ATAD患者的临床资料,患者均接受孙氏手术治疗,统计术后1周内谵妄发生率,采用单因素和多因素Logistic回归分析术后谵妄发生的影响因素。结果:176例ATAD患者中,术后1周内发生谵妄39例(22.16%),记为发生组,未发生谵妄137例(77.84%),记为未发生组;发生组有饮酒史、术中低血压、术中高血糖、术后血细胞比容(Hct)<30%、术后静脉镇痛及术后发生感染、心肌梗死、脑梗死者占比均高于未发生组,术后氧合指数低于未发生组,深低温停循环时间、体外循环时间均长于未发生组,差异有统计学意义(P<0.05);Logistic回归分析结果显示,有饮酒史、术中低血压、术中高血糖、深低温停循环时间过长、体外循环时间过长、术后氧合指数低、术后Hct<30%、术后静脉镇痛及术后发生感染、低体温、心肌梗死、脑梗死均是ATAD患者术后发生谵妄的独立危险因素(OR>1,P<0.05)。结论:ATAD患者术后谵妄发生率较高。有饮酒史、术中低血压、术中高血糖、深低温停循环时间过长、体外循环时间过长、术后氧合指数低、术后Hct<30%、术后静脉镇痛及术后发生感染、低体温、心肌梗死、脑梗死均是ATAD患者术后发生谵妄的独立危险因素。
Objective:To analyze influencing factors of postoperative delirium in patients with Stanford type A aortic dissection(ATAD).Methods:The clinical data of 176 patients with ATAD admitted to the hospital from January 2020 to December 2023 were retrospectively analyzed.All patients received Sun's surgery.The incidence of delirium within 1 week after the surgery was statistically analyzed.Univariate and multivariate Logistic regression analysis were performed on the related factors of postoperative delirium.Results:Among the 176 patients with ATAD,39 patients(22.16%) had postoperative delirium within 1 week after the surgery,which was recorded as the occurrence group,and 137 patients(77.84%) did not have postoperative delirium,which was recorded as the non-occurrence group.The proportions of the patients with drinking history,intraoperative hypotension,intraoperative hyperglycemia,postoperative hematocrit(Hct) <30%,postoperative intravenous analgesia,postoperative infection,myocardial infarction and cerebral infarction in the occurrence group were higher than those in the non-occurrence group,the postoperative oxygenation index was lower than that in the non-occurrence group,the deep hypothermic circulatory arrest time and cardiopulmonary bypass time were longer than those in the non-occurrence group,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that drinking history,intraoperative hypotension,intraoperative hyperglycemia,long deep hypothermic circulatory arrest time,long extracorporeal circulation time,low postoperative oxygenation index,postoperative Hct < 30%,postoperative intravenous analgesia,postoperative infection,hypothermia,myocardial infarction and cerebral infarction were independent risk factors for postoperative delirium(OR>1,P<0.05).Conclusions:The incidence of postoperative delirium in the patients with ATAD is high.Drinking history,intraoperative hypotension,intraoperative hyperglycemia,long time of deep hypothermic circulatory arrest,long extracorporeal
作者
黄剑锋
龚强
熊建英
黎杨
袁明明
吴起才
HUANG Jianfeng;GONG Qiang;XIONG Jianying;LI Yang;YUAN Mingming;WU Qicai(Department of Cardiac and Vascular Surgery of the First Affiliated Hospital of Nanchang University,Nanchang 330006 Jiangxi,China)
出处
《中国民康医学》
2024年第13期5-8,12,共5页
Medical Journal of Chinese People’s Health
基金
江西省教育厅科学技术研究项目(GJJ210142)。
