| 孙小珊,孔珉珉,孟 勇,刘东水,史会建.老年脊柱手术患者术后谵妄发生情况调查及相关影响因素分析[J].,2022,(13):2559-2563 |
| 老年脊柱手术患者术后谵妄发生情况调查及相关影响因素分析 |
| Investigation of Occurrence of Postoperative Delirium in Elderly Patients Undergoing Spinal Surgery and Analyze its Related Influencing Factors |
| 投稿时间：2022-01-23 修订日期：2022-02-18 |
| DOI：10.13241/j.cnki.pmb.2022.13.031 |
| 中文关键词: 老年 脊柱手术 术后谵妄 影响因素 |
| 英文关键词: Elderly Spinal surgery Postoperative delirium Influencing factors |
| 基金项目:山东省中医药科技项目（2021M190） |
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| 中文摘要: |
| 摘要 目的：调查老年脊柱手术患者术后谵妄发生情况，并分析其相关影响因素。方法：选取2018年7月~2021年5月我院收治的老年脊柱手术患者296例，统计其术后谵妄发生率，根据患者术后是否发生谵妄分为谵妄组和无谵妄组，采用单因素及多因素Logistic回归分析术后谵妄相关影响因素。结果：296例老年脊柱手术患者中有31例发生术后谵妄，术后谵妄发生率为10.47%。老年脊柱手术患者术后谵妄与手术时间、术前血红蛋白（Hb）水平、年龄、脑卒中病史、术中低氧血症、麻醉方式、手术部位、术前焦虑、苏醒时间、慢阻肺病史、术中低血压有关（P<0.05）。多因素Logistic回归分析结果显示：年龄≥70岁、手术时间≥120 min、术前Hb＜100 g/L、有慢阻肺病史、手术部位为颈椎、有术前焦虑、苏醒时间≥60 min、有术中低氧血症是老年脊柱手术患者术后发生谵妄的危险因素（P＜0.05）。结论：老年脊柱手术患者术后谵妄发生率较高，且受手术时间、年龄、术前Hb水平等多种因素影响，临床应结合相关因素制定针对性干预措施，以减少此类患者术后谵妄的发生几率。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the occurrence of postoperative delirium in elderly patients undergoing spinal surgery, and to analyze its related influencing factors. Methods: 296 elderly patients undergoing spinal surgery who were treated in our hospital from July 2018 to May 2021 were selected, and the incidence of postoperative delirium of their was counted. According to whether the patients had postoperative delirium, they were divided into delirium group and delirium free group, and the influencing factors of postoperative delirium were analyzed by univariate and multivariate Logistic regression. Results: Postoperative delirium occurred in 31 of 296 elderly patients undergoing spinal surgery, and the incidence of postoperative delirium was 10.47%. Postoperative delirium in elderly patients undergoing spinal surgery was associated with operation time, age, preoperative hemoglobin (Hb) level, stroke history, intraoperative hypoxemia, anesthesia method, surgical site, preoperative anxiety, wake up time, COPD history and intraoperative hypotension in elderly patients undergoing spinal surgery(P<0.05). Multivariate Logistic regression analysis showed that age ≥70 years, operation time ≥120 min, preoperative Hb <100 g/L, with COPD history, surgical site of cervical spine, with preoperative anxiety, wake up time ≥60 min and with intraoperative hypoxemia were the risk factors for postoperative delirium in elderly patients undergoing spinal surgery (P<0.05). Conclusion: The incidence of postoperative delirium in elderly patients undergoing spinal surgery is high, and the occurrence of postoperative delirium is affected by operation time, age, preoperative Hb level and other factors. Targeted intervention measures should be formulated in combination with relevant factors to reduce the incidence of postoperative delirium in such patients. |
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