| 老年患者脊柱手术术后谵妄发生的危险因素分析 |
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投稿时间：2024-01-18
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| 作者 | Author | 单位 | Address | E-Mail |
| 张维平 |
ZHANG Wei-ping |
甘肃省中医院, 甘肃 兰州 730050 |
Gansu Provincial Hospital of Trditional Chinese Medicine, Lanzhou 730050, Gansu, China |
zwp19891921@163.com |
| 常雯茜 |
CHANG Wen-xi |
甘肃省中医院, 甘肃 兰州 730050 |
Gansu Provincial Hospital of Trditional Chinese Medicine, Lanzhou 730050, Gansu, China |
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| 刘卫义 |
LIU Wei-yi |
甘肃中医药大学, 甘肃 兰州 730030 |
Gansu University of Traditional Chinese medicine, Lanzhou 730030, Gansu, China |
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| 李振军 |
LI Zhen-jun |
甘肃省中医院, 甘肃 兰州 730050 |
Gansu Provincial Hospital of Trditional Chinese Medicine, Lanzhou 730050, Gansu, China |
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| 毛建伟 |
MAO Jian-wei |
甘肃中医药大学, 甘肃 兰州 730030 |
Gansu University of Traditional Chinese medicine, Lanzhou 730030, Gansu, China |
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| 期刊信息：《中国骨伤》2024年，第37卷，第7期，第700-705页 |
| DOI：10.12200/j.issn.1003-0034.20230593 |
| 基金项目: |
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中文摘要:
目的：探讨老年患者脊柱手术后谵妄的危险因素。
方法：回顾性分析自 2021 年 1 月至 2023 年 1 月在全麻下行脊柱手术 566 例患者的基本病例资料,其中男 296 例,女 270 例;年龄(71.58±4.21)岁;颈椎手术 195 例,胸椎手术 26 例,腰椎手术 345 例。根据术后是否出现谵妄分为术后谵妄组 41 例与无谵妄组 525 例。对患者的性别、年龄、体重、吸烟史、饮酒史、手术部位、术前焦虑、术中低血压次数、失血量等可能影响因素进行单因素分析,并对 P<0.05 的单因素采用二元 Logistic 回归进行多因素分析。
结果：术后谵妄者 41 例,单因素分析显示,年龄(P=0.000)、手术时间(P=0.039)、术前焦虑(P=0.001)、失血量(P=0.000)、阿片类药物使用史(P=0.003)、脑卒中病史(P=0.005)、术后 C 反应蛋白(P=0.000)、术后钠离子(P=0.000)在谵妄组与非谵妄组间差异有统计学意义。将上述因素纳入二元 Logistic 回归分析,结果显示:年龄[OR=0.729,95%CI(0.569,0.932),P=0.012]、阿片类药物使用[OR=21.500,95%CI(1.334,346.508),P=0.031]、失血量[OR=0.932,95%CI (0.875,0.993),P=0.029]、术后 C 反应蛋白[OR=0.657,95%CI (0.485,0.890),P=0.007]、术前焦虑[OR=23.143,95%CI (1.859,288.090),P=0.015]、术后钠离子[OR=1.228,95%CI (1.032,1.461),P=0.020]是老年患者脊柱手术术后发生谵妄的独立危险因素。
结论：年龄、阿片类药物使用、失血量、术前焦虑、C 反应蛋白升高、低钠血症是老年患者脊柱手术术后谵妄发生的独立危险因素。 |
| 【关键词】脊柱手术 谵妄 危险因素 |
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| Analysis of risk factors for postoperative delirium in elderly patients undergoing spinal surgery |
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ABSTRACT
Objective To investigate the risk factors of postoperative delirium in elderly patients undergoing spine surgery.
Methods The basic case data of 566 patients who underwent spine surgery under general anesthesia from January 2021 to January 2023 were retrospectively analyzed. There were 296 males and 270 females with an average age of (71.58 ± 4.21) years old. There were 195 cases of cervical spine surgery,26 cases of thoracic spine surgery and 345 cases of lumbar spine surgery. According to the occurrence of postoperative delirium,the patients were divided into postoperative delirium group(41 patients) and non delirium group (525 patients). Univariate analysis was used to analyze the possible influencing factors such as gender,age,weight,smoking history,drinking history,surgical site,preoperative anxiety,intraoperative hypotension times,blood loss and so on,and binary Logistic regression was used to analyze the univariate factors with P<0.05.
Results A total of 41 patients developed postoperative delirium. Univariate analysis showed that age (P=0.000),duration of surgery (P=0.039),preoperative anxiety (P=0.001),blood loss (P=0.000),history of opioid use (P=0.003),history of stroke (P=0.005),C-reactive protein (P=0.000),sodium ion(P=0.000) were significantly different between delirium group and non delirium group. These factors were included in the binary Logistic regression analysis,and the results showed that age[OR=0.729,95% CI (0.569,0.932),P=0.012],opioid use[OR=21.500,95%CI (1.334,346.508),P=0.031],blood loss[OR=0.932,95%CI (0.875,0.993),P=0.029],C reactive protein[OR=0.657,95%CI (0.485,0.890),P=0.007],preoperative anxiety[OR=23.143,95%CI(1.859,288.090),P=0.015],and sodium[OR=1.228,95%CI(1.032,1.461),P=0.020] were independent risk factors for the development of delirium after spinal surgery in elderly patients.
Conclusion Age,opioid use,blood loss,preoperative anxiety,elevated c reactive protein,and hyponatremia are independent risk factors for the development of postoperative delirium in elderly patients undergoing spinal surgery. |
| KEY WORDS Spinal surgery Delirium Risk factors |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 张维平,常雯茜,刘卫义,李振军,毛建伟.老年患者脊柱手术术后谵妄发生的危险因素分析[J].中国骨伤,2024,37(7):700~705 |
| 英文格式: | ZHANG Wei-ping,CHANG Wen-xi,LIU Wei-yi,LI Zhen-jun,MAO Jian-wei.Analysis of risk factors for postoperative delirium in elderly patients undergoing spinal surgery[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(7):700~705 |
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