老年髋部骨折术后患者亚谵妄综合征影响因素分析  

The analysis of influencing factors of subdeliriurm syndrome in elderly patients with hip fracture

作　　者：洪飞 袁媛[1] 朱斌斌[1] 郑王萍[1] Hong Fei

机构地区：[1]宁波大学医学院附属医院,315000

出　　处：《浙江临床医学》2022年第11期1605-1608,共4页Zhejiang Clinical Medical Journal

基　　金：宁波市级重大专项科技项目(2019B10035-09)。

摘　　要：目的对老年髋部骨折术后患者的亚谚妄综合征(SSD)发生状况进行调查,并分析其影响因素。方法选取2020年4月至2021年12月行髋部骨折手术老年患者163例。采用镇静评估量表和意识模糊评估法进行谱妄症状评估。应用Logistic回归分析其术后SSD的影响因素。结果老年髋部骨折患者术后SSD发生率为55.2%,其中29例也存在妄状态;谱妄发生率为36.2%。单因素分析结果显示,性别、年龄、居住状态、合并慢性病数量、术前营养状态、白蛋白、手术时机、术中出血量、术中低血压和术后并发症是术后SSD的影响因素。Logistic回归结果显示,术前营养状态(OR=3.019)、合并慢性病数量(OR=3.407)、年龄(OR=2.172)和术中低血压(OR=2.675)是发生SSD的独立影响因素。结论患者入院后尽早开始营养评估与营养纠正、控制慢性病状况,术中关注循环系统管理,避免低血压发生,尤其是高龄患者,以降低SSD发生风险。ObjectiveTo explore the occurrence of subsyndromal delirium(SSD)in elderly patients after hip fractures surgery and its influencing factors.Methods Totlly 163 elderly patients after hip fractures surgery were admitted from Orthopedics Department in the Affiliated Hospital of medical school,Ningbo University from April 2020to December 2021.The Richmond Agitation-Sedation Scale and Confusion Assessment Method were used to assess delirium symptoms.Logistic regression was used to analyze the influencing factors of SSD.Results The incidence of SSD was 55.2%(90/163),in which 29 patients also had delirium symptoms.The incidence of delirium was 36.2%(59/163).The univariate analysis showed that gender,age,residence status,comorbidity,preoperative nutritional status,albumin,surgical timing,intraoperative bleeding,intraoperative hypotension,and postoperative complications were possible influencing factors for postoperative SSD.The Logistic regression showed that preoperative nutritional status(OR=3.019),comorbidity(OR=3.407),age(OR=2.172),and intraoperative hypotension(OR=2.675)were independent predictors of SSD.Conclusion Medical staff should start nutrition assessment and correction,control of chronic diseases as soon as possible after admission,pay attention to circulatory system management to avoid the occurrence of hypotension,especially in elderly patients,and reduce the risk of SSD.

关 键 词：老年 髋部骨折 亚谵妄综合征 影响因素 

分 类 号：R687.3[医药卫生—骨科学]