全麻老年患者术后认知功能障碍的危险因素  

Risk factors for postoperative cognitive dysfunction in elderly patients requiring general anesthesia

作　　者：陈政文[1] 丁顺才[1] 张玲[2] 

机构地区：[1]新疆医科大学第二附属医院麻醉科,乌鲁木齐市830000 [2]新疆维吾尔自治区人民医院老年病三科

出　　处：《中华麻醉学杂志》2013年第1期31-33,共3页Chinese Journal of Anesthesiology

摘　　要：目的筛选全麻老年患者术后认知功能障碍（POCk）的危险因素。方法择期全麻下行胸部或腹部手术的老年患者300例，年龄65～80岁，采用全凭静脉麻醉。根据术后3d是否发生认知功能障碍，将患者分为非POCD组和POCD组。记录患者一般资料及术前空腹血糖、糖化血红蛋白、血脂及血压。将组间差异有统计学意义的因素进行logistic回归分析，筛选POCD的危险因素。结果98例患者发生POCD，发生率为32．7％。logistic回归分析结果显示：高龄、糖尿病和高血压是POCD的独立危险因素（P〈0．05）。结论高龄、糖尿病和高血压是全麻老年患者POCD的独立危险因素。Objective To identify the risk factors for postoperative cognitive dysfunction （POCD） in the elderly patients requiring general anesthesia. Methods Three hundred elderly patients, aged 65-80 yr, scheduled for thoracic or abdominal surgery under general anesthesia, were enrolled in this study. Cognitive function was assessed by Mini-Mental State Examination （MMSE） at 1 day before operation and 3 days after operation. The patients were diagnosed as having POCD if MMSE 〈 21. The patients were assigned into POCD and non-POCD group. The general data, fasting plasma glucose, glycosylated hemoglobin （HbAlc） and blood pressure were measured. If there was no significant difference between the 2 groups, the factor was analyzed using logistic regression to select the risk factor for the incidence of POCD. Results Ninety-eight patients developed POCD （32.7 % ）. Logistic regression model showed that older age, diabetes and hypertension were independent risk factors for POCD （P 〈 0.05）. Conclusion Older age, diabetes and hypertension are independent risk factors for POCD in the eld- erly patients requiring general anesthesia.

关 键 词：认知障碍 手术后并发症 麻醉 全身 老年人 危险因素 

分 类 号：R614[医药卫生—麻醉学]