实用老年医学

实用老年医学 ›› 2023, Vol. 37 ›› Issue (10): 1019-1022.doi: 10.3969/j.issn.1003-9198.2023.10.010

• 临床研究 • 上一篇    下一篇

不同人格腹腔镜下子宫切除老年病人术后谵妄发生情况及危险因素分析

徐幻浠, 李先蕊, 吴浩, 许旭   

  1. 223800 江苏省宿迁市,南京医科大学附属宿迁第一人民医院麻醉科
  • 收稿日期:2022-12-04 出版日期:2023-10-20 发布日期:2023-10-19
  • 通讯作者: 李先蕊,Email:yejing0102005@163.com

Analysis of the incidence and risk factors of postoperative delirium in elderly patients with different personalities undergoing laparoscopic hysterectomy

XU Huan-xi, LI Xian-rui, WU Hao, XU Xu   

  1. Department of Anesthesiology,Suqian First People's Hospital Affiliated to Nanjing Medical University,Suqian 223800,China
  • Received:2022-12-04 Online:2023-10-20 Published:2023-10-19
  • Contact: LI Xian-rui, Email:yejing0102005@163.com

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摘要： 目的 探讨不同人格腹腔镜下子宫切除老年病人术后谵妄(POD)的发生情况及危险因素。 方法 选择腹腔镜下子宫切除的168例老年病人为研究对象,收集病人的年龄、Hb 水平、术中CO2气腹时间、CO2气腹压力、术中出血量、术前焦虑和术后疼痛控制情况及人格量表各维度评分等资料。根据其是否发生POD将所有病人分为POD组和非POD组,对POD发生的影响因素分别进行单因素与多因素二元Logistic回归分析。 结果 168例老年腹腔镜下子宫切除病人中有53例(31.55%)发生了POD,内向型人格病人POD发生率(48.08%)显著高于外向型(18.37%)和中间型(28.36%)(P<0.05)。多因素Logistic回归分析提示:年龄>70岁、术前贫血、CO2气腹时间＞90 min、术后疼痛控制不佳及内向型人格是POD发生的危险因素,而神经质维度评分＜43.3分(情绪稳定)则是POD的保护因素。 结论 腹腔镜下子宫切除老年病人有着较高的POD发生率,不同人格病人POD发生率有差异,年龄、CO2气腹时间、术后疼痛控制情况、内外向维度评分及神经质维度评分与POD的发生关系密切,应引起关注。

关键词: 人格, 老年人, 腹腔镜下子宫切除, 术后谵妄

Abstract: Objective To explore the incidence and risk factors of postoperative delirium(POD) in the elderly patients with different personalities undergoing laparoscopic hysterectomy. Methods A total of 168 elderly patients undergoing laparoscopic hysterectomy were enrolled in this study, and the related data such as age, hemoglobin level, CO2 pneumoperitoneum time and pressure, blood loss, preoperative anxiety and postoperative pain control, and the dimension score of personality questionnaire were observed and recorded. All the patients were divided into POD group and non-POD group according to whether they presented with POD. Single factor and multiple factor binary Logistic regression analysis were used to analyze the relevant factors for POD in the patients. Results Among 168 elderly patients undergoing laparoscopic hysterectomy, 53 cases (31.55%) presented with POD. The incidence of POD in the patients with introverted personality (48.08%) was significantly higher than that in the patients with extroverted (18.37%) and intermediate (28.36%) personality (P<0.05). Multivariate Logistic regression analysis showed that age >70 years, preoperative anemia, CO2 pneumoperitoneum time >90 min, poor postoperative pain control and internal and external dimension score <43.3 were the risk factors of POD, while neuroticism dimension score <43.3 was the protective factor of POD. Conclusions The elderly patients with laparoscopic hysterectomy have a high incidence of POD. The personalities show effects on the occurrence of POD.

Key words: personality, aged, laparoscopic hysterectomy, postoperative delirium

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