老年食管癌根治术患者术后谵妄的危险因素分析  

Analysis of risk factors for postoperative delirium in elderly patients undergoing radical resection of esophageal cancer

作　　者：张美霞 陈莉莉[2] 杨爱民[1] 周洋[1] 袁佳佳 Zhang Meixia;Chen Lili;Yang Aimin;Zhou Yang;Yuan Jiajia(Department of Thoracic Surgery,Tumor Hospital of Nantong City,Nantong,Jiangsu,226007,P.R.China;Intensive Care Unit,Tumor Hospital of Nantong City,Nantong,Jiangsu,226007,P.R.China)

机构地区：[1]南通市肿瘤医院胸外科,江苏南通226007 [2]南通市肿瘤医院重症监护室,江苏南通226007

出　　处：《老年医学与保健》2024年第5期1377-1381,共5页Geriatrics & Health Care

摘　　要：目的探讨老年食管癌根治术患者术后谵妄(POD)的危险因素。方法回顾性分析2020年9月—2023年9月于南通市肿瘤医院行食管癌根治术的76例老年患者的临床资料,根据是否发生POD分为POD组(16例)和非POD组(60例)。对比POD组和非POD组的临床资料,采用二元Logistic回归方法分析老年食管癌根治术患者发生POD的危险因素。结果2组性别、年龄、BMI、ASA分级、高血压史、糖尿病史、冠心病史、病变位置、手术时间、术中出血量、最低血红蛋白水平、住院时间指标值差异均无统计学意义(P>0.05);与非POD组相比,POD组在合并焦虑症、合并睡眠障碍、营养不良、预防性使用相关药物、术后疼痛评分≥4分、术后阿片类镇痛药物使用、合并低氧血症占比更高,入住ICU时间更长,差异均有统计学意义(P<0.05);二元Logistic回归分析结果显示,未预防性使用相关药物、术后疼痛评分≥4分、合并睡眠障碍、合并低氧血症为老年食管癌根治术患者发生POD的独立危险因素(P<0.05)。结论食管癌根治术老年患者POD的发生率较高,未预防性使用相关药物、术后疼痛评分≥4分、合并睡眠障碍、合并低氧血症可能是老年食管癌根治术患者发生POD的独立危险因素。Objective To explore the risk factors for postoperative delirium(POD)in elderly patients undergoing radical resection of esophageal cancer.Methods A retrospective analysis was performed on the clinical data of 76 elderly patients who underwent radical resection of esophageal cancer in Tumor Hospital of Nantong City between September 2020 and September 2023.According to presence or absence of POD,they were divided into POD group(16 cases)and non-POD group(60 cases).The clinical data of the two groups were compared.The risk factors for POD were analyzed by binary Logistic regression analysis.Results There were no statistically significant differences in gender,age,BMI,ASA grade,history of hypertension,history of diabetes,history of coronary heart disease,location of lesion,operation time,intraoperative blood loss,minimum hemoglobin level and hospital stay between the two groups(P>0.05).Compared with the non-POD group,the POD group had a higher proportion of patients with anxiety,sleep disorder,malnutrition,preventive use of related drugs,postoperative pain score≥4 points,postoperative use of opioid analgesics and hypoxemia,and a longer stay in ICU,with statistical significance(P<0.05).The results of binary Logistic regression analysis showed that no preventive use of relevant drugs,postoperative pain score≥4 points,sleep disorders,and hypoxemia were independent risk factors for POD in elderly patients undergoing radical resection of esophageal cancer(P<0.05).Conclusion The incidence of POD is high in elderly patients undergoing radical resection of esophageal cancer.No preventive use of related drugs,postoperative pain score≥4 points,sleep disorders and hypoxemia are independent risk factors for POD in these patients.

关 键 词：老年 食管癌 食管癌根治术 术后谵妄 危险因素 

分 类 号：R735.1[医药卫生—肿瘤]