额颞部肿瘤切除术后谵妄的危险因素分析  

Risk factors for postoperative delirium in patients undergoing fronto-temporal tumor resection

作　　者：白洋 王洁 曾敏[1] 彭宇明[1] BAI Yang;WANG Jie;ZENG Min;PENG Yuming(Department of Anesthesiology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院麻醉科,100070

出　　处：《临床麻醉学杂志》2025年第3期246-250,共5页Journal of Clinical Anesthesiology

摘　　要：目的分析额颞部肿瘤切除患者术后谵妄(POD)的危险因素。方法选择2021年1—12月行择期额颞部肿瘤切除术患者260例,男136例,女124例,年龄18~64岁,BMI 18.5~30.0 kg/m^(2),ASAⅠ—Ⅳ级。收集基线资料和围术期资料。采用Richmond躁动-镇静评分、监护室患者意识模糊评估法及3分钟意识模糊评估法相结合的方法,在术后5 d内每天两次评估POD的发生情况。根据术后5 d内是否发生POD将患者分为两组:POD组和非POD组。采用单因素和多因素Logistic回归分析POD发生的危险因素。结果有88例(33.8%)患者发生POD。多因素Logistic回归分析结果显示,年龄增大[校正后的比值比(aOR)=1.048,95%CI 1.021~1.076,P<0.001]、冠心病病史(aOR=31.504,95%CI 2.414~411.192,P=0.008)、肿瘤位于左侧(aOR=2.316,95%CI 1.259~4.262,P=0.007)、胶质瘤(aOR=3.042,95%CI 1.489~6.215,P=0.002)和麻醉时间延长(aOR=1.006,95%CI 1.002~1.009,P=0.001)是POD发生的独立危险因素。结论年龄增大、冠心病、胶质瘤、肿瘤位于左侧及麻醉时间延长是额颞部肿瘤切除术后发生POD的危险因素。Objective To investigate the risk factors of postoperative delirium(POD)in patients who underwent fronto-temporal tumor resection.Methods A total of 260 patients who underwent fronto-temporal tumor resection from January to December 2021 were included in this study,including 136 males and 124 females,aged 18-64 years,BMI 18.5-30.0 kg/m^(2),ASA physical statusⅠtoⅣ.Baseline and perioperative data were collected for all patients.To assess the incidence of postoperative delirium(POD),a combination of Richmond agitation-sedation scale,the confusion assessment method for the intensive care unit,and the 3-minute diagnostic interview for confusion assessment method were employed.Assessments were conducted twice daily from postoperative days 1 to 5.Patients were divided into two groups based on the occurrence of POD:the POD group and the non-POD group.Univariate and multivariate Logistic regression analysis were performed to identify risk factors associated with POD.Results POD occurred in 88 patients(33.8%).Multivariate Logistic regression analysis revealed that increased age[adjusted odds ratio(aOR)=1.048,95%confidence interval(CI)1.021-1.076,P<0.001],a history of coronary heart disease(aOR=31.504,95%CI 2.414-411.192,P=0.008),tumor location on the left side(aOR=2.316,95%CI 1.259-4.262,P=0.007),glioma histology(aOR=3.042,95%CI 1.489-6.215,P=0.002),and prolonged anesthesia duration(aOR=1.006,95%CI 1.002-1.009,P=0.001)were independent risk factors for POD.Conclusion Increased age,a history of coronary heart disease,prolonged anesthesia duration,tumor located in the left side,and glioma histology are identified as risk factors for the development of POD in patients undergoing fronto-temporal tumor resection.

关 键 词：额颞部肿瘤 术后谵妄 术后认知功能 

分 类 号：R73[医药卫生—肿瘤]