外科理论与实践

外科理论与实践 >

2024 , Vol. 29 >Issue 06: 510 - 517

DOI: https://doi.org/10.16139/j.1007-9610.2024.06.09

论著

影响老年病人全身麻醉非心脏手术术后谵妄发生的因素

  • 吴昕菀 ,
  • 李响 ,
  • 郑旻嘉 ,
  • 姚俊岩
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  • 上海交通大学医学院附属第一人民医院麻醉科，上海 200080
姚俊岩，E-mail: junyanyao@sjtu.edu.cn

收稿日期: 2024-01-19

  网络出版日期: 2025-03-17

基金资助

国家自然科学基金(81771269)

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Risk factors of postoperative delirium in elderly patients undergoing noncardiac surgery under general anesthesia

  • WU Xinwan ,
  • LI Xiang ,
  • ZHENG Minjia ,
  • YAO Junyan
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  • Department of Anesthesiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China

Received date: 2024-01-19

  Online published: 2025-03-17

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摘要

目的： 探讨老年病人择期全身麻醉（全麻）下行非心脏手术术后谵妄的发生率及其相关因素。方法： 回顾2017年12月31日至2018年12月31日全麻下接受非心脏手术、年龄≥65岁的老年病人，根据手术后是否出现谵妄分为谵妄组和对照组。谵妄组和对照组两组病人的实验室检查指标进行配对t检验，应用Logistic回归分析，明确老年病人行非心脏手术后谵妄发生的独立危险因素。结果： 本研究共纳入1 072例择期行非心脏手术的老年病人，其中60例发生谵妄，谵妄发生率为5.6%。多因素Logistic回归分析结果显示，术后凝血酶原时间（PT）、术前血糖、术前活化部分凝血活酶时间（APTT）、术后C反应蛋白（CRP）是老年病人非心脏手术术后谵妄发生的独立危险因素。结论： 老年病人接受非心脏手术后，术后PT、术前血糖、术前APTT、术后CRP构成术后谵妄发生的独立危险因素。

关键词： 谵妄; 老年; 全身麻醉; 非心脏手术; 危险因素

本文引用格式

吴昕菀 , 李响 , 郑旻嘉 , 姚俊岩 . 影响老年病人全身麻醉非心脏手术术后谵妄发生的因素[J]. 外科理论与实践, 2024 , 29(06) : 510 -517 . DOI: 10.16139/j.1007-9610.2024.06.09

Abstract

Objective To investigate the incidence and related factors of postoperative delirium in elderly patients undergoing elective noncardiac surgery under general anesthesia. Methods Elderly patients aged ≥65 years old undergoing non-cardiac surgery under general anesthesia from December 31, 2017 to December 31, 2018 were retrospectively analyzed. The patients were divided into delirium group and control group according to whether delirium occurred after surgery. Paired t test was used to compare the laboratory test results between the delirium group and the control group. Logistic regression analysis was used to identify the independent risk factors for delirium after non-cardiac surgery in elderly patients. Results A total of 1 072 elderly patients undergoing elective non-cardiac surgery were enrolled in this study. Delirium occurred in 60 patients, and the incidence of delirium was 5.6%. Multivariate Logistic regression analysis showed that postoperative prothrombin time(PT), preoperative blood glucose, preoperative activated partial thromboplastin time(APTT) and postoperative C-reactive protein(CRP) were independent risk factors for delirium after non-cardiac surgery in elderly patients. Conclusions Postoperative PT, preoperative blood glucose, preoperative APTT and postoperative CRP are independent risk factors for POD in elderly patients undergoing non-cardiac surgery.

Key words： Delirium; Old population; General anesthesia; Non-cardiac surgery; Risk factor

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