老年患者全身麻醉术后认知功能障碍的影响因素分析  

Analysis of Influencing Factors of Postoperative Cognitive Dysfunction in Elderly Patients After General Anesthesia

作　　者：张珏颢 马正良[1] 王小雨[1] 彭慧萍[1] 刘珊珊[1] 

机构地区：[1]南京大学医学院附属鼓楼医院麻醉科,江苏南京210008

出　　处：《现代生物医学进展》2015年第21期4071-4073,4108,共4页Progress in Modern Biomedicine

摘　　要：目的:探讨分析老年非心脏手术患者全身麻醉术后认知功能障碍(POCD)的影响因素。方法:选择我院80例老年行非心脏手术患者,所有患者均给予全身麻醉手术,于术前及术后1、3 d分别使用简易智能状态检查法(MMSE)评估患者认知功能,同时记录行不同手术种类患者POCD发生率并分析其年龄、麻醉时间、术中出血量、并发症情况及受教育程度等指标与POCD发生的相关性。结果:80例患者POCD发生率为30.0%,且不同种类手术中的发生率比较差异无统计学意义(P>0.05);POCD组术后1d MMSE评分为较术前分明显下降,比较差异具有统计学意义(P<0.05);POCD组术后3 d及非POCD组术后1、3 d MMSE评分与术前比较差异无统计学意义(P>0.05);Logistic回归分析显示,患者年龄、文化程度、麻醉持续时间≥3 h、术中出血量≥350 m L及合并高血压与POCD的发生具有显著相关性(P<0.05)。结论:行全麻手术患者术后POCD发病率较高,且患者高龄、文化程度低、高血压合并症及麻醉持续时间长等是引起POCD发生的重要影响因素。Objective： To investigate the influence factors of postoperative cognitive dysfunction （POCD） in elderly patients with non cardiac operation after general anesthesia. Methods： A total of 80 elderly patients with non cardiac operation in Drum Tower Hospital were selected, who were given general anesthesia operation, using the mini mental state examination （MMSE） function to evaluate the cognitive function in the patients 1 d and 3 d before and after operation and to record incidence of POCD in different types of operation and to analyze the correlation of the age, time of anesthesia, amount of bleeding during operation, the complications and the education level of the patients with the occurrence of POCD. Results： The incidence of POCD of the 80 patients was 30%; there was no significant difference in incidence among different types of operation（P〉0.05）; MMSE score of the POCD group ld after operation was significantly decreased compared with before operation, with significant difference （P〈0.05）; there were no statistical differences in MMSE score 3d after operation in POCD group and ld and 3d after operation in the non POCD group （P〉0.05）; Logistic regression analysis showed that the patients＇ age （≥ 70 years）, cultural level （≤years）, duration of anesthesia （≥ 3h）, intraoperative bleeding volume （〉 350ml） and complicated with hypertension had a significant correlation with POCD （P〈0.05）. Conclusion： The incidence rate of POCD is higher for the patients after general anesthesia operation, and the patients＇ age, low educational level, complications of hypertension and longer duration of anesthesia are important influence factors for occurrence of POCD.

关 键 词：老年患者 全身麻醉 认知功能障碍 

分 类 号：R592[医药卫生—老年医学] R614[医药卫生—内科学]