文章摘要
褚 晓,傅 娆,徐文婷,叶 菊,陆 真.术前衰弱对老年心脏手术患者术后跌倒坠床发生率、认知功能和日常生活活动能力的影响分析[J].,2022,(23):4441-4444
术前衰弱对老年心脏手术患者术后跌倒坠床发生率、认知功能和日常生活活动能力的影响分析
Effects Analysis of Preoperative Frailty on the Incidence of Falls and Falls in Bed, Cognitive Function and Activities of Daily Living in Elderly Patients Undergoing Cardiac Surgery
投稿时间:2022-05-23  修订日期:2022-06-18
DOI:10.13241/j.cnki.pmb.2022.23.008
中文关键词: 衰弱  老年  心脏手术  跌倒坠床  认知功能  日常生活活动能力
英文关键词: Frailty  Elderly  Cardiac surgery  Falls and falls in bed  Cognitive function  Activities of daily living
基金项目:江苏省卫生厅科研基金项目(H2017219)
作者单位E-mail
褚 晓 江苏省人民医院心脏大血管外科 江苏 南京 210000 xuewuji_1@163.com 
傅 娆 江苏省人民医院心脏大血管外科 江苏 南京 210000  
徐文婷 江苏省人民医院心脏大血管外科 江苏 南京 210000  
叶 菊 江苏省人民医院心脏大血管外科 江苏 南京 210000  
陆 真 江苏省人民医院心脏大血管外科 江苏 南京 210000  
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中文摘要:
      摘要 目的:探讨术前衰弱对老年心脏手术患者术后跌倒坠床发生率、认知功能和日常生活活动能力的影响。方法:选择我院2018年1月~2021年1月收治的271例拟行心脏手术的老年患者,按照术前是否合并衰弱情况,将患者分别纳入衰弱组、非衰弱组,对比两组患者术后跌倒坠床发生率、并发症发生率、住院时间及术前、术后认知功能和日常生活活动能力的变化。结果:271例患者中,共有78例(28.78%)符合衰弱判断。衰弱组术后跌倒坠床、并发症发生率高于非衰弱组,其住院时间较非衰弱组更长,差异有统计学意义(P<0.05)。两组患者术后7 d简易智力精神状态检查量表(MMSE)评分均较术前下降,衰弱组术后7 d MMSE评分低于非衰弱组,差异有统计学意义(P<0.05)。衰弱组术后认知功能障碍(POCD)发生率为11.54%(9/78),高于非衰弱组的1.04%(2/193),差异有统计学意义(P<0.05)。两组患者术后7 d基础性日常生活活动能力(BADL)及工具性日常生活活动能力(IADL)评分均较术前下降,衰弱组术后7 d BADL、IADL评分低于非衰弱组,差异有统计学意义(P<0.05)。结论:合并术前衰弱的老年患者较非衰弱患者心脏手术后跌倒坠床发生率、并发症发生率更高,认知功能、日常生活活动能力受影响越明显,且术后恢复速度更慢。
英文摘要:
      ABSTRACT Objective: To analyze the effect of preoperative frailty on the incidence of falls and falls in bed, cognitive function and activities of daily living in elderly patients undergoing cardiac surgery. Methods: 271 elderly patients who planned to undergo cardiac surgery in our hospital from January 2018 to January 2021 were selected. According to whether they were combined with frailty before operation, the patients were included in the frailty group and the non-frailty group respectively. The incidence of falls and falls in bed after operation, the incidence of complications, the hospital stay, the cognitive function after operation and activities of daily living changes were compared between the two groups. Results: Among 271 patients, 78 (28.78%) were in line with the judgment of frailty. The incidence of postoperative falls, falls in bed and complications in the frailty group was higher than that in the non frailty group, and the hospital stay was longer than that in the non-frailty group, the hospital stay was longer than that in the non-frailty group, and the differences were statistically significant (P<0.05). The Mini-Mental State Examination (MMSE) scores of the patients in the two groups at 7 d after operation decreased compared with that before operation, the MMSE scores of the frailty group were lower than those of the non-frailty group at 7 d after operation, and the differences were statistically significant (P<0.05). The incidence of postoperative cognitive dysfunction (POCD ) in the frailty group was 11.54% (9/78), which was higher than 1.04% (2/193) in the non-frailty group, and the difference was statistically significant (P<0.05). The scores of basic activities of daily living (BADL) and instrumental activities of daily living (IADL) in the two groups at 7 d after operation decreased compared with those before operation. The scores of BADL and IADL in the frailty group were lower than those in the non-frailty group at 7 d after operation, and the differences were statistically significant (P<0.05). Conclusion: Compared with elderly patients with preoperative frailty, the incidence of falls and falls in bed and incidence of complications after cardiac surgery are higher than those in non-weak patients. The cognitive function and activities of daily living are more affected, and the recovery speed is slower.
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