| 徐维昉,李新琳,陈丽丽,龙 飞,张 晨.老年骨科全麻患者术后麻醉恢复室谵妄的影响因素分析及防范措施[J].,2021,(4):724-727 |
| 老年骨科全麻患者术后麻醉恢复室谵妄的影响因素分析及防范措施 |
| Analysis of Influencing Factors and Preventive Measures of Postoperative Delirium in Anesthesia Recovery Room of Elderly Patients with Orthopedic General Anesthesia |
| 投稿时间：2020-08-18 修订日期：2020-09-13 |
| DOI：10.13241/j.cnki.pmb.2021.04.026 |
| 中文关键词: 老年 骨科 全麻 谵妄 影响因素 防范措施 |
| 英文关键词: Elderly Orthopedics General anesthesia Delirium Influencing factors Preventive measures |
| 基金项目:新疆维吾尔自治区自然科学基金项目（2017D01C287） |
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| 中文摘要: |
| 摘要 目的：分析老年骨科全麻患者术后麻醉恢复室谵妄的影响因素，并探讨相关防范措施。方法：选取2018年7月-2020年6月期间我院收治的200例老年骨科全麻患者，收集患者的临床资料。根据其术后麻醉恢复室是否出现谵妄分为观察组（术后发生谵妄）和对照组（术后未发生谵妄），分析术后麻醉恢复室谵妄的影响因素。结果：200例老年骨科全麻患者中，发生术后谵妄的患者83例，发生率为41.50%（83/200）。单因素分析结果显示，老年骨科全麻患者术后麻醉恢复室谵妄与年龄、合并其它基础疾病、吸烟史、术前血糖、术前血红蛋白、术前红细胞压积、手术类型、术中失血量、电解质紊乱有关（P<0.05），而与性别、体质量指数（BMI）、Zung 焦虑自评量表（SAS）评分、术前总蛋白、抑郁自评量表（SDS）评分、血钾、手术时间无关（P>0.05）。多因素Logistic回归分析结果显示：年龄＞75岁、合并其它基础疾病、术前血红蛋白＜12g/dl、术中失血量≥200 mL、电解质紊乱均为老年骨科全麻患者术后发生谵妄的危险因素（P<0.05）。结论：引起老年骨科全麻患者术后麻醉恢复室谵妄的危险因素较多，包括年龄、合并其它基础疾病、术前血红蛋白、术中失血量、电解质紊乱等，临床应采取必要的防范措施，合理制定手术方案，以降低患者术后谵妄的发生率。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the influencing factors of postoperative delirium in anesthesia recovery room of elderly orthopedic patients under general anesthesia, and to discuss the relevant preventive measures. Methods: From July 2018 to June 2020, 200 elderly patients with general anesthesia in orthopedics department in our hospital were selected, and the clinical data of patients were collected. The patients were divided into observation group (postoperative delirium) and control group (postoperative delirium) according to the postoperative anesthesia recovery room delirium. The influencing factors of postoperative delirium in anesthesia recovery room were analyzed by Multivariate logistic regression analysis. Results: There were 83 cases of postoperative delirium in 200 cases of elderly orthopedic general anesthesia patients, the incidence rate was 41.50% (83 / 200). Univariate analysis showed that Delirium in the recovery room of elderly orthopedic patients after general anesthesia was associated with age, other basic diseases, smoking history, preoperative blood glucose, preoperative hemoglobin, preoperative hematocrit, type of operation, intraoperative blood loss and electrolyte disorder (P<0.05), while it was associated with gender, body mass index (BMI), Zung There was no correlation between SAS score, preoperative total protein, SDS score, serum potassium and operation time (P>0.05). Multivariate logistic regression analysis showed that age > 75 years old, complicated with other basic diseases, preoperative hemoglobin < 12 g / dl, intraoperative blood loss ≥ 200 mL, electrolyte disturbance were the risk factors of postoperative delirium in elderly orthopedic patients under general anesthesia (P<0.05). Conclusion: There are many risk factors causing delirium in the anesthesia recovery room of elderly orthopedic patients after general anesthesia, including age, other basic diseases, preoperative hemoglobin, intraoperative blood loss, electrolyte disorder and so on. We should take necessary preventive measures and formulate reasonable operation plan in order to reduce the incidence of postoperative delirium. |
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