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老年患者术后精神障碍的发病率及相关因素研究

  • 孙英群

* 通信作者: 孙英群, 单位:北京市大兴区红星医院麻醉科 100076

摘要


目的 探讨分析老年患者术后精神障碍的发病率及相关因素。

方法 以自2011年1月至2016年6月期间我院麻醉科ICU中收治的年龄大于65岁术后患者187例为研究对象。于术后1个月时进行评价分析。以患者年龄、性别、是否合并高血压或糖尿病、围手术期是否发生低血压或低氧血症等作为分组因素,比较不同组间患者术后发生精神障碍的发生率,将有意义的因素再次引入Logistic回归方程,筛选出术后发生精神障碍的独立危险因素。

结果 至术后1个月时,共有33例患者出现精神障碍,发生率为17.6%。其中骨科20例,泌尿科9例,普外科和普胸各2例。单因素分析

结果显示,患者是否合并高血压或糖尿病、围手术期是否发生低血压或低氧血症与术后精神障碍的发生显著相关(P<0.05),年龄、性别及术后是否使用镇痛泵与术后精神障碍的发生无显著相关性(P<0.05)。将术后有无精神障碍作为因变量,上述具有统计学意义的分组因素作为自变量,经Logistic逐步回归分析

结果显示,患者合并高血压或糖尿病、围手术期发生低血压或低氧血症均为术后发生精神障碍的独立危险因素(P<0.05)。

结论 老年患者出现术后精神障碍系多个因素协同作用所致,其中合并高血压或糖尿病、围手术期发生低血压或低氧血症均可视为术后发生精神障碍的独立危险因素,应有针对性的加强预防,以降低术后精神障碍的发生率,促进患者康复。

关键词:老年;术后精神障碍;发病率;相关因素

ABSTRACT


Objective: To analyze the morbidity and influence factors of postoperative mental disorder. Method: 187 elderly patients (>65 years old) treated from January 2011 to June 2016 in the anesthesia department and ICU were selected. After 1m of surgery, the patient’s condition was evaluated. The influence factors included the patient’s age, gender, extracorporeal circulation, complication of hypertension/diabetes and incidence of hypotension/hypoxemia. The morbidity of mental disorder was observed. Through the Logistic regression equation, the independent risk factors of mental disorder were analyzed. Result: After 1m of surgery, there were 33 cases of mental disorder (17.6%) Among them, 20 cases were Department of orthopedics, 9 cases were in the urinary tract, 2 cases in the Department of general surgery and cases in the chest. The morbidity of mental disorder for patients of adopting the extracorporeal circulation was 40%; according to the single factor analysis, the incidence of mental disorder had an obvious correlation with the complication of hypertension/diabetes, incidence of hypotension/hypoxemia and extracorporeal circulation (P<0.05); the incidence of mental disorder had no obvious correlation with the patient’s age or gender (P<0.05); through the Logistic regression equation, the independent risk factors of mental disorder included the complication of hypertension/diabetes, incidence of hypotension/hypoxemia and extracorporeal circulation (P<0.05).

Conclusion  : The multiple influence factors have influenced the morbidity of mental disorder. The independent risk factors of mental disorder include the complication of hypertension/diabetes, incidence of hypotension/hypoxemia and extracorporeal circulation.The corresponding prevention measures can reduce the morbidity of mental disorder and promote the patient’s recovery.

Key words: Elderly; Postoperative mental disorder;Morbidity;Influence factor

引用本文 / How to Cite This Article

孙英群.老年患者术后精神障碍的发病率及相关因素研究[J]. 国际精神病学杂志, 2018, 45(2): 334-336

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