非糖尿病老年患者直肠癌切除术后谵妄的危险因素分析  

Risk factors for postoperative delirium after rectal cancer resection in non-diabetic elderly patients

作　　者：刘思羽 林旭[2] 王彬[2] 吴晓月 王菲[4] 张浩然 毕燕琳[2] LIU Siyu;LIN Xu;WANG Bin;WU Xiaoyue;WANG Fei;ZHANG Haoran;BI Yanlin(School of Anesthesiology,Shandong Second Medical University,Weifang 261053,China)

机构地区：[1]山东第二医科大学麻醉学院,山东潍坊261053 [2]青岛市市立医院东院麻醉科 [3]大连医科大学麻醉学系 [4]南京医科大学麻醉学系

出　　处：《精准医学杂志》2024年第6期531-534,共4页Journal of Precision Medicine

基　　金：国家自然科学基金资助项目(91849126)。

摘　　要：目的探究非糖尿病老年患者直肠癌切除术后谵妄(POD)发生的危险因素。方法从围术期神经认知障碍疾病风险因素和预后(PNDRFAP)研究中收集542例患者的临床资料,根据患者是否发生POD将其分为POD组(80例)和非POD组(462例)。比较两组患者的性别、年龄、受教育年限、术前空腹血糖(FBG)水平、术前血清糖化血红蛋白(HbA1c)水平、术前简易精神状态测验(MMSE)评分、是否发生POD等指标,并采用logistic回归模型分析患者术后POD发生的影响因素。结果患者POD的发生率为14.8%。POD组患者年龄、受教育年限、术前FBG水平、术前MMSE评分与非POD组比较有显著差异(t=-5.420、-2.121,Z=-12.691、-7.753,P<0.05)。Logistic分析结果显示,患者术前FBG水平升高(OR=1.149,95%CI=1.012~1.305,P<0.05)是术后POD发生的危险因素。结论术前FBG水平升高是非糖尿病患者直肠癌切除术POD发生的危险因素之一。Objective To investigate the risk factors for postoperative delirium(POD)after rectal cancer resection in non-diabetic elderly patients.Methods The clinical data of 542 patients were collected from the Perioperative Neurocognitive Disorder Risk Factor and Prognosis study,and according to the presence or absence of POD,they were divided into POD group with 80 patients and non-POD group with 462 patients.The two groups were compared in terms of sex,age,years of education,fasting blood glucose(FBG)before surgery,glycosylated hemoglobin before surgery,Mini-Mental State Examination(MMSE)score before surgery,and the presence or absence of POD,and the logistic regression model was used to investigate the influencing factors for POD in patients.Results The incidence rate of POD was 14.8%among these patients.There were significant diffe-rences between the POD group and the non-POD group in age,years of education,preoperative FBG level,and preoperative MMSE score(t=-5.420,-2.121,Z=-12.691,-7.753,P<0.05).The logistic regression analysis showed that the increase in preoperative FBG level(OR=1.149,95%CI=1.012-1.305,P<0.05)was a risk factor for POD.Conclusion The increase in preoperative FBG level is one of the risk factors for POD in non-diabetic patients after rectal cancer resection.

关 键 词：谵妄 手术后并发症 直肠肿瘤 血糖 禁食 影响因素分析 

分 类 号：R619[医药卫生—外科学]