老年髋部骨折患者术前心理状况及术后谵妄影响因素分析  

Analysis of influencing factors of preoperative mental state and postoperative delirium in elderly patients with hip fracture

作　　者：杨晓敏[1] 孙玉娟[1] 李桂秋 Yang Xiaomin;Sun Yujuan;Li Guiqiu(Zhengzhou Orthopaedic Hos pital,ZhenNg zhou 450052,Henan.China)

机构地区：[1]郑州市骨科医院,河南郑州450052

出　　处：《临床心身疾病杂志》2020年第6期103-106,共4页Journal of Clinical Psychosomatic Diseases

摘　　要：目的 探讨老年髋部骨折患者术前心理状况及术后谵妄的影响因素.方法 对124例老年髋部骨折患者采用焦虑自评量表、抑郁自评量表评定术前心理状态,监测术后谵妄发生情况,分析术后谵妄的影响因素.结果 老年髋部骨折患者出现术前焦虑22例(17.7%),术前抑郁20例(16.1%),术后谵妄28例(22.6%).单因素分析显示,不同年龄、术中出血量、麻醉方式,是否罹患高血压、糖尿病、冠心病,术前焦虑、术前抑郁患者术后谵妄发生率比较差异有统计学意义(P<0.05或0.01);多因素Logistic回归分析显示,患者年龄>80岁、高血压、糖尿病、冠心病、全身麻醉、术前焦虑与抑郁是影响患者术后谵妄的独立危险因素(P<0.05或0.01).Pearson相关分析显示,患者术前焦虑、术前抑郁与术后谵妄发生率呈显著正相关(P<0.05).结论 老年髋部骨折患者术前焦虑、抑郁率及术后谵妄发生率均较高,术后谵妄影响因素较多,其中术前焦虑及抑郁与术后谵妄有密切关系.Objective To investigate the influencing factors of preoperative mental state and postoperative delirium in elderly patients with hip fracture.Methods 124 elderly patients with hip fracture were as-sessed by SAS and SDS to assess their preoperative mental status,monitor the occurrence of postoperative delirium,and analyze the influencing factors of postoperative delirium.Results Elderly patients with hip fractures had preoperative anxiety in 22 cases(17.7%),preoperative depression in 20 cases(16.1%),and postoperative delirium in 28 cases(22.6%).Univariate analysis showed that there were statistically sig-nificant differences in the incidence of postoperative delirium among patients with different ages,intraoper-ative blood loss,anesthesia met hods,hypertension,diabetes,coronary heart disease,preoperative anxie-ty,and preoperative depression(P<0.05 or 0.01).Multivariate logistic regression analysis showed that patients'age>80 years,hypertension,diabetes,coronary heart disease,general anesthesia,preoperative anxiety and depression were independent risk factors for postoperative delirium(P<0.05 or 0.01).Pear-son correlation analysis showed that preoperative anxiety,preoperative depression and postoperative deliri-um were significantly positively correlated(P<0.05).Conclusions The rate of anxiety and depression before operation and delirium after operation are higher in elderly patients with hip fracture.There are many factors influencing postoperative delirium,among which there is a positive correlation between pre-operative depression and anxiety and postoperative delirium incidence.

关 键 词：髋部骨折 老年 焦虑 抑郁 谵妄 影响因素 

分 类 号：R683.3[医药卫生—骨科学] R473.74[医药卫生—外科学]