腹腔镜胃肠手术术后认知功能障碍的危险因素分析  

Risk factors of postoperative cognitive dysfunction in patients undergoing gastrointestinal laparoscopy

作　　者：毕江江[1] 王金韬[1] 万里[1] 罗爱林[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院麻醉科

出　　处：《临床外科杂志》2015年第11期855-857,共3页Journal of Clinical Surgery

基　　金：国家自然科学基金资助项目(30901390)

摘　　要：目的：分析腹腔镜胃肠手术患者发生术后认知功能障碍（postoperative cognitive dys-function，POCD）的危险因素。方法腹腔镜胃肠手术患者85例（腹腔镜组），开腹胃肠手术患者80例（开腹组），分别于术前1天、术后第1天和第7天进行简易智力状态检查（Mini Mental State Examination，MMSE），并进行 Logistic 多因素回归分析。结果腹腔镜组和开腹组患者术后第1天POCD 的发生率分别为24.71％和27.50％，第7天分别为18.82％和21.25％，两组在两个时间点分别比较，差异均无统计学意义（P ﹥0.05）。Logistic 回归分析显示，腹腔镜手术中，年龄、气腹时间、麻醉时间与 POCD 的发生呈正相关。结论腹腔镜和开腹胃肠手术后 POCD 的发生率比较差异无统计学意义，患者的年龄、气腹时间以及麻醉时间是腹腔镜患者术后 POCD 的危险因素。Objective To analyze the potential risk factors of postoperative cognitive dysfunction （POCD）in patients undergoing gastrointestinal laparoscopy. Method There were 85 patients undergoing gastrointestinal laparoscopy（GL）and 80 patients undergoing open surgery（OS）. Mini mental state ex-amination was performed on the day before operation and the 1st and 7th day after operation. The scores were evaluated by multi-factor logistic regression analysis. Result The incidences of POCD in GL and OS patients on the 1st day after surgery were 24. 71% and 27. 50% ,while it was 18. 82% and 21. 25% on the 7th day after surgery（P ﹥ 0. 05）. Logistic regression analysis revealed that age,duration of CO2 pneumoperitoneum and duration of anesthesia were positively related to the occurrence of POCD. Conclu-sion Thereˊs no significant difference between the incidences of POCD in OS and GL patients. Age,du-ration of CO2 pneumoperitoneum and anesthesia are the risk factors of POCD in patients undergoing GL.

关 键 词：术后认知功能障碍 腹腔镜 简易智力状态检查 

分 类 号：R614[医药卫生—麻醉学]