老年结直肠癌手术患者术后谵妄影响因素分析  

Influencing factors of postoperative delirium in elderly patients undergoing colorectal cancer surgery

作　　者：陶欢欢[1] 韩雪静 赵鑫[1] 徐伟锋 Tao Huanhuan;Han Xuejing;Zhao Xin;Xu Weifeng(The First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,Henan,China;不详)

机构地区：[1]河南科技大学第一附属医院,河南洛阳471000 [2]河南省肿瘤医院,河南郑州450000

出　　处：《临床心身疾病杂志》2025年第2期111-115,共5页Journal of Clinical Psychosomatic Diseases

基　　金：河南省医学科技攻关计划联合共建项目(编号LHGJ20200185)。

摘　　要：目的 探讨老年结直肠癌手术患者发生术后谵妄(POD)的影响因素,并分析其与术前负性情绪的相关性。方法 选取2021年5月~2023年12月行结直肠癌手术的81例老年患者作为研究对象,并根据是否发生POD,将患者分为POD组(28例)和非POD组(53例)。收集所有患者的一般资料,采用意识模糊评估量表(CAM)、医院焦虑抑郁量表(HADS)评估患者POD状况和负性情绪。采用二元Logistic回归分析探讨老年结直肠癌手术患者发生POD的影响因素。结果81例老年结直肠癌手术患者发生POD 28例,POD发生率为34.57%。POD组患者年龄,初中及以下文化程度、有饮酒史、剖腹手术、手术时间≥200 min、腹腔引流管数量>2支、镇痛泵累计使用量≥3个的人数占比以及术前HADS评分高于非POD组(P<0.05或0.01)。二元Logistic回归分析结果显示:高年龄、初中及以下文化程度、有饮酒史、剖腹手术、手术时间≥200 min、腹腔引流管数量>2支、镇痛泵累计使用量≥3个、术前HADS评分(负性情绪)均是老年结直肠癌手术患者发生POD的危险因素(P<0.05或0.01)。结论 老年结直肠癌手术患者POD发生率较高,且影响因素较多。需要针对影响因素制定相应的应对措施,以最大限度地降低POD的发生率。Objective To explore the factors influencing the occurrence of postoperative delirium(POD)in elderly patients undergoing colorectal cancer surgery and analyze their correlations with preoperative negative emotions.Methods Eighty-one elderly patients undergoing colorectal cancer surgery from May 2021 to Dec.2023 were selected as research objects and divided into POD(n=28)and non-POD(n=53)group according to whether postoperative POD occurred.General data of all patients were collected,the Confusion Assessment Method(CAM)and Hospital Anxiety and Depression Scale(HADS)used to assess POD condition and negative emotions.Binary Logistic regression analysis was used to explore the factors influencing the occurrence of the POD in elderly patients undergoing colorectal cancer surgery.Results Of 81 elderly patients undergoing colorectal cancer surgery,28 developed the POD,and POD incidence was 34.57%.Patients'ages were older,educational level of junior middle school and below,drinking history,laparotomy,operation time≥200 minutes,number of abdominal drainage tubes>2 and cumulative amount of analgesic pump≥3 proportion as well as preoperative HADS score were higher in POD than non-POD group(P<0.05 or 0.01).Binary Logistic regression analysis showed that advanced age,educational level of junior middle school and below,drinking history,laparotomy,operation time≥200 minutes,number of abdominal drainage tubes>2,cumulative amount of analgesic pump≥3,and preoperative HADS(negative emotions)score were all risk factors for the occurrence of the POD in elderly patients undergoing colorectal cancer surgery(P<0.05 or 0.01).Conclusion The incidence of the POD in elderly patients with colorectal cancer surgery is higher and influencing factors are more.Corresponding coping measures should be formulated aiming at influencing factors to lower the incidence of the POD to the fullest extent.

关 键 词：老年 结直肠癌 手术 负性情绪 术后谵妄 影响因素 

分 类 号：R473.73[医药卫生—护理学] R395.1[医药卫生—临床医学]