术前营养不良与老年人髋部骨折术后谵妄的相关性研究  

Relationship between postoperative delirium and preoperative nutrition in elderly patients with hip fracture

作　　者：文新平 贾黎[1] 韩英华 尹继霞 吴春兵 邹超斌 毛拥军[1] WEN Xin-ping;JIA Li;HAN Ying-hua;YIN Ji-xia;ZOU Chao-bin;MAO Yong-jun;WU Chun-bing(Department of Geriatrics,Qingdao University Affiliated Hospital,Qingdao 266000,China;Department of Orthopedics,Qingdao University Affiliated Hospital,Qingdao 266000,China)

机构地区：[1]青岛大学附属医院老年医学科,山东省青岛市266003 [2]青岛大学附属医院骨科,山东省青岛市266003

出　　处：《实用老年医学》2020年第5期451-453,461,共4页Practical Geriatrics

基　　金：国家重点研发计划(2018YFC2002102)。

摘　　要：目的探讨术前营养状态与老年人髋部骨折术后谵妄的相关性。方法纳入2017年9月至2019年6月于我院行髋部骨折手术的年龄≥65岁的病人102例。术前采用简易营养评估法(MNA-SF)评估所有病人的营养状况,根据评估结果将研究对象分为营养正常组、营养不良风险组及营养不良组。术后1~3 d采用意识错乱评估方法(the confusion assessment method,CAM)评估病人是否处于谵妄状态,并使用多因素Logistic回归分析术后谵妄的危险因素,探讨术前营养状态与术后谵妄的关系。结果 102例病人根据营养状态分为营养正常组43例(42. 2%),营养不良风险组33例(32. 4%),营养不良组26例(25. 4%)。术后谵妄发生率为27. 45%(28/102)。多因素Logistic回归分析显示,有营养不良风险的病人(OR=6. 095,95%CI=1. 113~33. 368)和营养不良的病人(OR=22. 446,95%CI=3. 499~143. 995)更有可能发生术后谵妄。结论使用MNA-SF评估的营养不良和营养不良风险是术后谵妄的独立危险因素。因此,在手术前应评估老年人髋部骨折病人的营养状况,以更好地预防术后谵妄的发生。Objective To determine the relationship between preoperative nutritional status and postoperative delirium(PD) in the elderly patients undergoing hip fracture surgery.Methods A total of 102 patients hospitalized in our hospital from September 2017 to June 2019 aged 65 years and over with hip fractures who underwent THA were enrolled.They underwent the assessment of nutritional status with Mini Nutritional Assessment Short Form(MNA-SF).The confusion assessment method(CAM) was used to evaluate the state of PD.Logistic regression analysis was carried out to assess the risk factors of PD.Results All patients were divided into normal nutrition group(n=43),malnutrition risk group(n=33) and malnutrition group(n=26) according to nutritional status.The incidence rate of PD was 27.45%.Multivariate Logistic regression analysis showed that malnutrition risk and malnutrition patients were risk factors of PD,with OR(95%CI) of 6.095(1.113-33.368) or 22.446(3.499-143.995),respectively.Conclusions The risk of malnutrition and malnutrition assessed by MNA-SF are independent risk factors for PD.Therefore,the nutritional status of elderly patients with hip fracture should be evaluated before operation in order to better prevent PD.

关 键 词：老年人 髋部骨折 营养 术后谵妄 

分 类 号：R681.1[医药卫生—骨科学]