老年胸外科患者术后急性精神障碍相关危险因素分析  

Analysis of risk factors for postoperative acute mental disorders in elderly patients with chest surgery

作　　者：李明涛[1] 王小平[1] 

机构地区：[1]第四军医大学唐都医院,西安710038

出　　处：《国际精神病学杂志》2015年第5期117-121,共5页Journal Of International Psychiatry

摘　　要：目的探讨老年胸部手术患者术后急性精神障碍发生的相关因素分析。方法收集216例在我院接受胸部手术的老年患者的围术期临床资料,按照患者术后是否出现急性精神障碍分为病例组(n=30例)和对照组(n=186例),比较两组患者相关临床资料的差异,并利用Logistic回归分析探讨影响术后急性精神障碍发生的危险因素。结果有30例发生急性精神障碍(发生率13.9%);单因素分析提示两组患者在合并基础病、术前血清白蛋白≤35 g/L、手术方式、术中MAP、术中失血量、手术时间、术后低氧血症、术后电解质紊乱、术后胸腔引流量存在统计学差异(P<0.05);经过多因素Logistic回归分析最终筛选出合并基础病、术前血清白蛋白≤35 g/L、手术方式、术中MAP<60 mmH g、手术时间、术后低氧血症、术后电解质紊乱是影响术后急性精神障碍发生的独立危险因素(P<0.05)。结论老年胸部手术术后胸急性精神障碍的发生受到多种因素的影响,临床中应当重视此类高危因素,以制定相关干预措施降低术后精神障碍的发生率。Objective To explore the risk factors for postoperative acute mental disorders in elderly patients with chest surgery. Methods 216 cases of elderly patients undergoing chest surgery in our hospital were collected,the all cases were divided into case group（ n = 30） and control group（ n = 186） according to the postoperative acute mental disorders; comparing the difference between the two groups of patients with clinical information,and Logistic regression analysis was used to study effects of the risk factors of postoperative acute mental disorders occurred. Results 30 cases of postoperative acute mental disorders incidence（ 13. 9%）; Single factor analysis showed that the merger disease,preoperative serum albumin ≤35g / L,surgical type,intraoperative MAP,intraoperative blood loss,operative time,postoperative hypoxemia,electrolyte disorder after operation,postoperative chest of statistical differences（ P〈0. 05）; multiariable Logistic regression analysis finally showed that select merge disease preoperative serum albumin≤35g / L OR less,surgical type,intraoperative MAP 60 mmH g,operation time and postoperative hypoxemia,postoperative electrolyte disorders were independent risk factors for postoperative acute mental disorders（ P〈0. 05）. Conclusion Postoperative acute mental disorders in elderly chest surgery influenced by many factors,such should be paid great attention to in the clinical risk factors,to develop the related intervention measures to reduce the incidence of postoperative acute mental disorders.

关 键 词：胸部手术 术后急性精神障碍 危险因素 

分 类 号：R749[医药卫生—神经病学与精神病学]