老年患者腹部手术后认知功能障碍的高危因素分析  

Clinical Analysis of Risk Factors of Postoperative Cognitive Dysfunction in Elderly Patients after Abdominal Surgery

作　　者：刘利[1] 丁思勤[1] 汪振亮[1] 张华洲[1] 

机构地区：[1]西安医学院第二附属医院普外科,陕西西安710038

出　　处：《中国普外基础与临床杂志》2011年第9期987-990,共4页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的分析老年患者腹部手术后认知功能障碍(POCD)发生的高危因素。方法回顾性分析我院2000年2月至2010年10月期间60岁以上2 286例腹部手术后患者的临床资料,根据是否发生POCD将2 286例患者分为POCD组和非POCD组,其中POCD组38例,非POCD组2 248例。分析影响腹部手术后POCD发生的影响因素,包括年龄、性别、麻醉方式、术前是否用药〔地西泮和(或)阿托品或东莨菪碱〕、术前是否存在心肺疾病、术前是否有糖尿病、术前有无黄疸、术前有无贫血或低蛋白血症、手术持续时间及术后是否进行持续镇痛治疗。结果 POCD的发生与患者年龄、麻醉方式、术前是否存在心肺疾病、术前是否有糖尿病、术前有无黄疸、手术持续时间是否超过4 h、术后是否进行持续镇痛有关(P<0.05),而与患者性别、术前是否用药和术前有无贫血或低蛋白血症无关(P>0.05)。结论年龄≥70岁、全身麻醉、术前存在心肺疾病、糖尿病和黄疸、手术持续时间超过4 h、术后未进行持续有效的镇痛是腹部手术后POCD发生的高危因素。Objective To analyze the risk factors of postoperative cognitive dysfunction（POCD） in elderly patients after abdominal surgery.Methods The clinical data of 2 286 patients over 60 years old after abdominal surgery were retrospectively analyzed,which were divided into non-POCD group with 2 248 patients and POCD group with 38 patients.The influencing factors of POCD in elderly patients after abdominal surgery,including the age,gender,anesthetic way,the premedication,cormobided with lung or heart disease,diabetes,jaundice,anemia or hypoproteinemia,the duration of surgery,and postoperative analgesia protocols,were analyzed between two groups.Results The age,anesthetic way,cormobided with lung or heart disease,diabetes,jaundice,with or without continuous postoperative effective analgesia,and surgery duration over four hours were relevant with POCD（P0.05）,while gender,the premedication,and preexisted anemia or hypoproteinemia were not relevant with that（P0.05）.Conclusion Age over 70 years,general anaesthesia,cormobided with lung or heart disease,diabetes,jaundice,surgery duration over four hours,and incomplete postoperative analgesia are the risk factors of POCD after abdominal surgery.

关 键 词：腹部手术 术后认知功能障碍 高危因素 

分 类 号：R749.2[医药卫生—神经病学与精神病学]