人格因素对老年患者胃肠外科术后认知功能障碍发生的影响  

Effects of personality on development of postoperative cognitive dysfunction in elderly patients undergoing gastrointestinal surgery

作　　者：刘华琴[1] 周超[1] 宋子贤[1] 付建峰[1] 

机构地区：[1]河北医科大学第四医院麻醉科,石家庄市050011

出　　处：《中华麻醉学杂志》2016年第3期281-284,共4页Chinese Journal of Anesthesiology

摘　　要：目的 评价人格因素对老年患者胃肠外科术后认知功能障碍（POCD）发生的影响.方法 择期全麻下行胃肠手术的老年患者58例,性别不限,年龄65 ～ 70岁,ASA分级Ⅱ或Ⅲ级.术前1d对患者进行艾森克人格问卷测试,艾森克人格问卷测试P量表评分＜50分,采用2＆#215;2两因素析因设计,试验因素为性格内向或外向（因素A）、神经稳定性（因素B）,A1和A2分别为性格内向（艾森克人格问卷测试E量表评分＜50分）和性格外向（艾森克人格问卷测试E量表评分≥50分）,B1和B2分别为神经稳定性好（艾森克人格问卷测试N量表评分＜50分）和神经稳定性差（艾森克人格问卷测试N量表评分≥50分）.按各因素不同水平排列组合,将患者分为4组：A1B1组（n=8）、A1B2组（n=10）、A2B1组（n=26）和A2B2组（n=14）.于术后7d进行认知功能测试,记录POCD发生情况.结果 A1B1组、A1B2组、A2B1组和A2B2组POCD发生率分别为0、0、15％、57％,A2B1组POCD发生率高于A1B1组和A1B2组,A2B2组POCD发生率高于其它3组（P＜0.05）.因素A与因素B均对POCD的发生有影响（P＜0.01）,且二者间存在交互作用（P＜0.01）.结论 性格外向和神经稳定性差的非精神质患者POCD的发生机率较高.Objective To evaluate the effects of personality on the development of postoperative cognitive dysfunction （POCD） in elderly patients undergoing gastrointestinal surgery.Methods Fifty-eight elderly patients,aged 65-70 yr,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,with Eysenck Personality Questionnaire （EPQ） P rating scale score 〈50,scheduled for elective gastrointestinal surgery under general anesthesia,were enrolled in the study.Personality was assessed by using EPQ at 1 day before surgery.By using a 2 ＆#215; 2 factorial design,2 empirical factors introversion or extroversion （factor A） and neuroticism （factor B） were used.A1 and A2 were introversion （EPQ E rating scale score〈50） and extroversion （EPQ E rating scale score ≥ 50）,respectively.B1 and B2 were emotional stability （EPQ N rating scale score〈50） and emotional instability （EPQ N rating scale score ≥ 50）,respectively.The patients were divided into 4 groups：A1B1 group （n=8）,A1B2 group （n=10）,A2B1 group （n=26）,and A2B2 group （n =14）.Cognitive function was assessed at 7 days after surgery,and the development of POCD was recorded.Results The incidence of POCD was 0,0,15% and 57% in A1B1,A1B2,A2B1and A2 B2 groups,respectively,the incidence of POCD was significantly higher in group A2B1 than in A1B1and A1 B2 groups,and the incidence of POCD was significantly higher in group A2B2 than in the other three groups （P〈0.05）.Factor A and factor B produced effects on the development of POCD （P〈0.01）,and an interaction between them was found （P〈0.01）.Conclusion The incidence of POCD is higher for the non-mentation patients who are extroverted and emotionally unstable.

关 键 词：人格 老年人 认知障碍 手术后并发症 

分 类 号：R614[医药卫生—麻醉学]