老年颅内肿瘤术后患者应激障碍严重程度与危险因素分析  

Analysis of severity and risk factors of stress disorder in elderly patients after intracranial tumor surgery

作　　者：丁富萍 李鑫[1] 陈宁[1] 张慧鑫 Ding Fuping;Li Xin;Chen Ning;Zhang Huixin(Comprehensive Ward 1,International Department,Beijing Tiantan Hospital Affiliated to Capital Medical University,100160,Beijing,P.R.China)

机构地区：[1]首都医科大学附属北京天坛医院国际部综一病房,北京丰台100160

出　　处：《老年医学与保健》2025年第1期25-31,共7页Geriatrics & Health Care

摘　　要：目的探究老年颅内肿瘤术后患者应激障碍严重程度特征及危险因素。方法回顾性分析2022年5月—2024年5月在首都医科大学附属北京天坛医院接受手术治疗的209例老年颅内肿瘤患者临床资料,通过创伤性应激障碍自评量表(PTSD-SS)评估患者术后PTSD发生率及严重程度。对比不同临床特征、病情及治疗特点的患者间PTSD发生率差异。采用Logistic回归模型分析老年颅内肿瘤术后患者发生PTSD的危险因素。结果老年颅内肿瘤术后患者PTSD发生率为24.4%;年龄较大、无社会支持、颅内肿瘤位于幕下、术中出血量≥500 mL、手术时间≥4 h、麻醉持续时间≥5 h的老年颅内肿瘤术后患者发生PTSD风险显著较高(P<0.05);单因素及多因素Logistic回归分析表明,年龄较大、颅内肿瘤部位在幕下、术中出血量≥500 mL、手术持续时间≥4 h、麻醉持续时间≥5 h均是老年颅内肿瘤术后患者发生PTSD的危险因素,社会支持水平较高是老年颅内肿瘤术后患者发生PTSD的保护因素(P<0.05)。结论年龄较大、缺乏社会支持、肿瘤部位在幕下、术中出血量较多、手术持续时间及麻醉时间较久的老年颅内肿瘤术后患者可能更容易发生PTSD。Objective To explore the characteristics of the severity and risk factors of stress disorder in elderly patients after intracranial tumor surgery.Methods The clinical data of 209 elderly patients with intracranial tumors who underwent surgical treatment in Beijing Tiantan Hospital Affiliated to Capital Medical University from May 2022 to May 2024 were retrospectively analyzed.The incidence and severity of postoperative post-traumatic stress disorder(PTSD)were assessed by the PTSD Self-Rating Scale(PTSD-SS).The differences in the incidence of PTSD among patients with different clinical characteristics,disease conditions,and treatment features were compared.The Logistic regression model was used to analyze the risk factors for PTSD in elderly patients after intracranial tumor surgery.Results The incidence of PTSD in these patients was 24.4%.The risk of PTSD was significantly higher in elderly patients with intracranial tumor who were older and lack of social support,and had infratentorial tumor location,intraoperative blood loss≥500 mL,operative time≥4 h,and anesthesia duration≥5 h(P<0.05).Univariate and multivariate Logistic regression showed that advanced age(OR=2.31,95%CI:1.423.76),infratentorial tumor location(OR=3.15,95%CI:1.855.38),intraoperative blood loss≥500 mL(OR=2.89,95%CI:1.675.01),operation duration≥4 h(OR=2.45,95%CI:1.38-4.34),and anesthesia duration≥5 h(OR=2.12,95%CI:1.213.72)were all risk factors for PTSD in elderly patients after intracranial tumor surgery,while a higher level of social support was a protective factor(OR=0.45,95%CI:0.280.73)(P<0.05).Conclusion Elderly postoperative intracranial tumor patients who are older and lack social support,and have infratentorial tumor location,significant intraoperative blood loss,longer operation and anesthesia duration are more likely to develop PTSD.

关 键 词：老年 颅内肿瘤 创伤 应激障碍 影响因素 保护因素 

分 类 号：R74[医药卫生—神经病学与精神病学]