老年髋部骨折术后谵妄的危险因素分析  

作　　者：诸葛军[1] 熊良平[1] 

机构地区：[1]浙江省建德市第一人民医院,311600

出　　处：《浙江临床医学》2016年第8期1463-1464,共2页Zhejiang Clinical Medical Journal

摘　　要：目的探讨老年髋部骨折患者术后发生谵妄的高危因素。方法回顾性分析2014年12月至2015年12月行髋部骨折手术的老年患者97例，根据是否发生术后谵妄分为谵妄组（18例）和非谵妄组（79例）。记录患者的年龄、性别、体重指数、手术时间、术中出血量等指标。采用单因素和多因素Logistic归分析术后谵妄的危险因素。结果共18例患者出现术后谵妄，发生率为18．6％。单因素危险分析表明，谵妄组和非谵妄组在年龄、BMI、受伤至手术间隔时间、手术时间、术中失血量、术后疼痛评分和术后睡眠时间减少方面差异有统计学意义（P〈0．05）。多因素回归分析显示高龄、低BMI、手术时间长、术后疼痛评分高、术后睡眠时间减少是谵妄的独立危险因素。结论老年髋部骨折术后谵妄的发生率高，高龄、低BMI、手术时间长、术后疼痛评分高和术后睡眠时间减少是术后谵妄的高危因素，在围手术期要综合防治。Objective To discuss the high risk factors of postoperative delirium in elderly patients with hip fracture. Methods From December 2014 to December 2015, 97 patients with hip fracture were surgically treated, which were divided into delirium-group （ 18 cases ） and non-delirium- group （ 79 cases ） . Patients＇ age, sex, body mass index, duration of surgery, intraoperative blood loss and so on were recorded. Univariate and multivariate Logistic regression analysis were used on the risk factors of postoperative delirium. Results There were 18 cases on postoperative delirium （ the incidence rate for 18.6% ） . Univadate logistic regression analysis showed that there were significant differences between delirium-group and non- delirium-group in age, BMI, injuries to the operative interval, duration of surgery, intraoperative and postoperative blood loss, postoperative pain scores and sleep time decreased （ P〈0.05 ） . Meanwhile multivariate analysis showed old age, low BMI, long operation time and high postoperative pain scores, reduced sleep time were independent risk factors for delirium. Conclusion The incidence of postoperative delirium in elderly patients with hip fracture is high. old age, low BMI, duration of surgery, postoperative pain scores high and reduce sleep time are the high risk factors of postoperative delirium which should be integrated controlled in perioperative period.

关 键 词：术后谵妄 髋部骨折 高龄 危险因素 

分 类 号：R683.3[医药卫生—骨科学]