老年患者脊柱手术后谵妄的危险因素分析

发布时间：2018-11-18 09:33

【摘要】：目的:探讨老年患者脊柱手术后谵妄的发病率及相关危险因素。方法:2011年1月至2012年12月随机选取200例老年脊柱手术病人进行研究,分别对性别、年龄、麻醉方式、手术部位(颈椎、胸椎、腰椎)、手术时间、复苏时间、术前心理状态、术后睡眠情况、是否合并基础疾病(高血压、冠心病、糖尿病、高脂血症、慢支炎)、出血量、术中血压情况等因素进行统计,logistic回归分析相关因素对老年患者脊柱手术后谵妄发生的影响。结果:老年患者脊柱手术后谵妄总发生率为11%(22/200);logistic回归分析显示:老年患者脊柱手术后谵妄与性别、术中出血量和是否合并基础疾病等因素无明确关系(P0.05);而与年龄、麻醉方式、手术部位、手术持续时间、术后复苏时间、术中低血压、术前心理状态和术后睡眠障碍等因素关系密切(P0.05),OR值及其95%CI分别为7.107(0.238 1~1.211 6)、12.613(0.869 5~6.086 2)、6.978(-5.865 9~-1.131 7)、3.697(0.194 8~6.070 5)、5.367(1.014 1~7.701 0)、3.012(0.067 7~5.517 9)、6.078(1.130 4~6.555 2)、3.018(-6.798 9~-0.668 05)。结论:老年患者脊柱手术后谵妄发病率较高,高龄、全麻、长时间手术或复苏、术中低血压、术前心理状态不稳和术后睡眠障碍是其主要危险因素。
[Abstract]:Objective: to investigate the incidence and risk factors of delirium after spinal surgery in elderly patients. Methods: from January 2011 to December 2012, 200 elderly patients undergoing spinal surgery were randomly selected to study gender, age, anaesthesia, site of operation (cervical spine, thoracic vertebra, lumbar vertebra), time of operation, time of resuscitation, psychological state before operation. After the operation, whether there are basic diseases (hypertension, coronary heart disease, diabetes mellitus, hyperlipidemia, chronic bronchitis), blood loss, intraoperative blood pressure, etc. Effect of logistic regression analysis on delirium after spinal surgery in elderly patients. Results: the total incidence of delirium in elderly patients after spinal surgery was 11% (22 / 200). Logistic regression analysis showed that there was no clear relationship between sex, intraoperative blood loss and underlying diseases in elderly patients with postoperative delirium after spinal surgery (P0.05). However, it was closely related to age, anaesthesia, site of operation, duration of operation, time of postoperative resuscitation, intraoperative hypotension, preoperative psychological state and postoperative sleep disorder (P0.05). The values of OR and 95%CI were 7.107 (0.238 1.2116), 12.613 (0.869 5 卤6.086 2), 6.978 (-5.865 9 / -1.131 7), 3.697 (0.194 8 卤6.070 5), respectively. 5.367 (1.014 1 / 7.7010), 3.012 (0.067 7 / 5.517 9), 6.078 (1.130 4 / 6.5552), 3.018 (-6.798 9 / -0.668 05). Conclusion: the incidence of delirium after spinal surgery in elderly patients is high. The main risk factors are old age, general anesthesia, long-term operation or resuscitation, intraoperative hypotension, preoperative psychological instability and postoperative sleep disorder.
【作者单位】：重庆医科大学附属永川医院神内科;重庆医科大学附属永川医院脊柱外科;
【基金】：重庆市永川区科技资助项目(编号:YCSTC,2011BE5010)
【分类号】：R687.3

【参考文献】