胸腹部手术对患者术后认知功能的影响及相关危险因素分析  

Influence of Thoracic and Abdominal Surgery on Patients' PostoPerative Cognitive Function and Related Risk Factor Analysis

作　　者：苏柏勤 游志坚[1] 洪璞[1] 蒋珊[1] 李集源 SU Bai-qin YOU Zhi-jian HONG Pu JIANG Shan LI Ji-yuan(Department of Anesthesiology, The Second Affiliated Hospital Shantou University Medical College, Shantou 515041, China Department of Anesthesiology, Foshan First People＇s Hospital, Shunde 528300, China)

机构地区：[1]汕头大学医学院第二附属医院麻醉科,广东汕头515041 [2]佛山市顺德区第一人民医院麻醉科,广东顺德528300

出　　处：《汕头大学医学院学报》2017年第1期26-28,共3页Journal of Shantou University Medical College

摘　　要：目的:观察腹部手术及单肺通气(SLV)下胸科手术对患者术后认知功能的影响,分析相关危险因素。方法:择期手术患者分为腹部和胸科组(各35例),分别在全麻下行腹部和胸科手术,其中胸科组用SLV。健康志愿者35例为对照组。手术组于术前1天及术后第7天行认知功能评价,对照组在相同时间间隔评估认知功能。根据各组发生术后认知功能障碍(POCD)情况,将单因素分析中差异有统计学意义的变量进一步作Logistic回归分析,筛选POCD危险因素。结果:胸科和腹部组与对照组POCD发生率分别为40.0%、17.1%、0.0%;与对照组比,胸科和腹部组POCD发生率明显增高(P<0.05);与腹部组比,胸科组POCD发生率明显增高(P<0.05)。3组共有20例POCD。Logistic逐步回归分析结果:年龄≥60岁、SLV时间是胸腹部手术患者POCD的危险因素。结论:胸科、腹部手术均可引起患者POCD,SLV可能是导致POCD发生率较高的重要因素,且随SLV时间延长患者发生POCD的风险增加。Objective：To observe the influence of thoracic and abdominal surgery on patients＇ posto-perative cognitive function,and to analyze related risk factors.Methods：The patients for selected single-lung ventilation（SLV） assisted thoracic surgery（GroupT,n=35）and for abdominal surgery（GroupA,n=35）were recruited in this study.Thirty-five healthy volunteers were recruited as the control group（GroupC）.The cognitive function in the operation groups were evaluated on the day before surgery and day after surgery,and the cognitive function in the control group was evaluated at same time interval.Factors which were significantly different between groups would be analyzed using logistic regression to select the risk factors for the occurrence of POCD.Results：The incidence of POCD in Group T,A and C was 40.0%,17.1%and 0.0%respectively（P〈0.05）.Compared to Cgroup,incidence of T group and A group was significantly higher（P〈0.05）.Compared to Group A,POCD incidence in the Group T was significantly higher（P〈0.05）.Totally 20 patients developed POCD among groups.Logistic regression analysis showed that aged 60 years or over and SLV duration were risk factors for POCD insurgery patients.Conclusion：Patients can develop POCD after thoracic surgery and abdominal surgery.SLV may be the main reason for higher POCD incidence,and long SLV duration may increase risk of developing POCD in patients.

关 键 词：外科手术 老年 单肺通气 术后认知功能障碍 

分 类 号：R614.2[医药卫生—麻醉学]