老年患者术后精神和认知障碍的发病率及相关因素分析  

Morbidity and related factors of postoperative mental and cognitive disorder in elderly patients

作　　者：曹建国[1] 洪涛[1] 闻大翔[1] 皋源[1] 万燕杰 刁枢[3] 李立志[4] 杭燕南[1] 孙大金[1] 

机构地区：[1]上海交通大学医学院附属仁济医院麻醉科,200001 [2]上海市公利医院麻醉科 [3]上海市第七人民医院麻醉科 [4]上海市浦东新区人民医院麻醉科

出　　处：《上海医学》2005年第11期939-941,共3页Shanghai Medical Journal

基　　金：上海市浦东新区科技局资助项目(pkj200413)

摘　　要：目的研究老年患者术后精神障碍和认知功能障碍的发病率及相关因素。方法对上海仁济医院2000年1月至2005年4月的380例年龄≥65岁的老年患者进行术后精神障碍测定;对上海仁济医院及其合作医院2004年4月至2005年4月期间年龄≥65岁的135例非神经、非心血管手术的老年患者进行术后认知障碍测定。结果外科重症监护病房术后精神障碍的发生率为17.9%,体外循环、合并高血压、糖尿病及围术期低血压是主要相关因素。老年患者非心脏手术后认知功能障碍的发生率为29.6%,年龄及术中低血压持续时间是重要相关因素。结论老年患者术后精神与认知功能障碍与体外循环、合并高血压、糖尿病、围术期低血压、年龄及术中低血压时间相关。Objective To analyze the morbidity and related factors of postoperative mental and cognitive disorder in elderly patients. Methods To study the morbidity of postoperative mental disorder and cognitive disturbance in 515 elderly patients, ≥65 years, retrospectively in Shanghai Renji Hospital and some cooperative hospitals from Jan. 2000 to Apt 2005. Results Among our study population, the rate of postoperative mental and cognitive disorder was 17. 9% including cardiopulmonary bypass （CPB） with coexisted diseases of hypertension or diabetes mellitus （DM）, perioperative hypotension as the main related factors. 29.6 % elderly patients under non-cardiac surgery had cognitive disorder outcome with due to the important related. Age and duration factors of age and time of hypotension during surgical operation. Conclusions The incidence of postoperative mental and cognitive disorders is related to CPB,accompanying hypertension or DM, age and durations of perioperative together with intraoperative hypotension.

关 键 词：老年患者 术后 精神障碍 认知障碍 

分 类 号：R619[医药卫生—外科学]