经尿道前列腺电切术患者术后谵妄相关因素研究  

Analysis on Relevant Factors of Postoperative Delirium in Transurethral Resection of the Prostate

作　　者：张建军[1,2] 蔡维奇[1,2] 方先林[1,2] 董洁[1,2] 嵇福荣[1,2] 张绍奇[1,2] 殷中玲[1,2] 

机构地区：[1]徐州医学院附属宿迁医院 [2]南京鼓楼医院集团宿迁市人民医院泌尿外科,江苏省宿迁市223800

出　　处：《中国全科医学》2013年第3期255-257,共3页Chinese General Practice

摘　　要：目的分析经尿道前列腺电切术(TURP)患者术后谵妄的发病情况及其围术期相关因素。方法回顾性分析我院2008年1月—2011年10月412例行TURP的良性前列腺增生患者的临床资料,包括年龄、吸烟史、饮酒史(≥3次/周)、高血压病史、糖尿病病史、冠心病病史、既往手术史、服用安眠药史、术前焦虑、术后镇痛、术后膀胱痉挛、术后睡眠障碍和术后缺氧的发生情况。将可能与术后发生谵妄的相关因素进行多因素非条件Logistic回归分析。结果 27例患者发生术后谵妄,发生率为6.6%(27/412)。经单因素分析,不同年龄、有无饮酒史、有无高血压病史、有无术前焦虑、有无术后镇痛、有无术后膀胱痉挛、有无术后睡眠障碍及有无术后缺氧比较,差异均有统计学意义(P<0.20);并进行多因素非条件Logistic回归分析显示,年龄〔OR=3.854,95%CI(1.601,9.279),P=0.003〕、高血压病史〔OR=3.732,95%CI(1.448,9.622),P=0.006〕、术后膀胱痉挛〔OR=4.450,95%CI(1.693,11.700),P=0.002〕、术后睡眠障碍〔OR=3.122,95%CI(1.283,7.594),P=0.012〕、术后缺氧〔OR=4.196,95%CI(1.330,13.237),P=0.014〕进入回归方程。结论高龄、高血压病史、术后膀胱痉挛、术后睡眠障碍、术后缺氧是TURP患者术后发生谵妄的危险因素。Objective To investigate the prevalence of delirium and perioperative factors after transurethral resection of the prostate（TURP）. Methods Clinical data（including age,smoking history,drinking history,hypertension history,diabetes history,coronary heart disease history,operation history,history of taking sleeping pills,preoperative anxiety,postoperative analgesia,postoperative cystospasm,postoperative sleep disturbance and postoperative ischemia）of 412 benign prostatic hyperplasia patients underwent TURP in our hospital from January 2008 to October 2011 were retrospectively analyzed.Possible relevant factors for postoperative delirium were analyzed by using multiple factor logistic regression analysis. Results 27 patients had postoperative delirium with an occurrence rate of 6.6%（27/412）.According to single factor analysis,age,history of drinking,history of hypertension,preoperative anxiety,postoperative analgesia,postoperative cystospasm,postoperative sleep disorder and postoperative ischemia all showed statistically significant differences（P0.20）.Multiple factor unconditional Logistic regression analysis showed that age（OR=3.854,95%CI（1.601,9.279）,P=0.003）,history of hypertension（OR=3.732,95%CI（1.448,9.622）,P=0.006）,postoperative cystospasm（OR=4.450,95%CI（1.693,11.700）,P=0.002）,postoperative sleep disturbances（OR=3.122,95%CI（1.283,7.594）,P=0.012）,postoperative ischemia（OR=4.196,95%CI（1.330,13.237）,P=0.014） entered the regression equation. Conclusion Postoperative cystospasm,senior age,the history of hypertension,postoperative sleep disturbances and postoperative ischemia are risk factors for postoperative delirium in transurethral resection of the prostate.

关 键 词：经尿道前列腺切除术 谵妄 前列腺增生 危险因素 

分 类 号：R697.32[医药卫生—泌尿科学] R749.2[医药卫生—外科学]