老年髋关节手术后急性精神障碍的影响因素  

The influenced factors of acute postoperative cognitive dysfunction of hip-joint surgery in the elderly

作　　者：王嘉鹏[1] 林霞[2] 李贵斌[1] 

机构地区：[1]吉林大学第四医院骨科,长春市130011 [2]吉林大学第二医院放疗科

出　　处：《中国临床研究》2013年第3期218-220,共3页Chinese Journal of Clinical Research

摘　　要：目的探讨老年髋关节骨折及关节置换术后的患者术后急性精神障碍(POCD)发生的影响因素及防治方法。方法对2007年5月至2012年4月共317例行髋关节周围手术的60岁以上的老年患者的临床资料进行无筛选回顾性分析及随访,应用MMSE方式评估,统计其POCD发生率。结果老年髋关节周围手术后POCD发生率22.4%(71/317),与文献报道基本相同,发生POCD的危险因素包括术前、术中与术后等原因,POCD的发生对患者术后康复有明显影响。结论手术前应尽可能调整患者全身状况,积极治疗基础疾病;术中尽可能避免各种诱发因素,完善围术期心理疗法;一旦出现精神症状宜早期给药,积极处理;重视POCD的防治将有利于术后患者的康复。Objective To explore the related risk faL＇tors of acute postoperative cognitive dysfunction （POCD） after hip-joint fracture and hip-joint displacement in the elderly and the prevention and treatment. Methods The no-screening retrospective analysis and follow-up were carried out in consecutive 317 patients aged more than 60 years underwent peri-hip joint operations between May 2007 and April 2012 and assessed by Mini-Mental State Examination（MMSE）. The incidence of POCD was summed. Results The incidence of POCD in peri-hip joint operation in the elderly was 22.4% （71/317） ,and it was in good agreement with literature reports. The risk factors of POCD included the causes of pre-operation,inter-operation amt post-operation. The occurring of POCD had a obvious influence on patients＇ postoperative rehabilitation. Conclusions The general state before operation should be modified to the full, and the basic diseases should be treated. The inducing factors at inter-operation should be avoided. The psychological therapy of peri-operation period should be perfected. Once occurring psychological symptom, early medication and active treatment should be given. Paying attention to prevention and therapy of POCD will benefit patients＇ postoperative rehabilitation.

关 键 词：髋关节骨折 髋关节置换 髋关节手术 急性精神障碍 老年 

分 类 号：R683.42[医药卫生—骨科学] R749.2[医药卫生—外科学]