全麻术后认知功能障碍的相关因素分析

【摘要】 目的 分析气管插管全麻术后认知功能障碍(POCD)的相关因素。方法〓选取择期非心脏手术全麻病人267例,于术前1天、术后1天、术后3天采用MMSE量表进行认知功能评定,术后发生认知功能障碍的患者为PD组,未发生认知功能障碍的患者为NPD组。同时记录年龄,性别,文化程度,ASA分级,既往史,心电图,肝功能,术前用药,术中用药,手术时间,出血量,输血量,术后疼痛视觉模拟评分(VAS评分),术后心动过速、高血压等情况,进行相关因素及多元Logistic回归分析。结果〓POCD与年龄,ASA分级,吸烟史,东莨菪碱,阿托品,手术时间,输血,出血量,术中低血压,术后高血压,术后VAS评分差异等因素有关,通过Logistic回归分析结果年龄,手术时长,低血压及VAS评分是POCD的危险因素。结论〓年龄,手术时长,低血压及VAS评分是POCD的危险因素。

Analysis of related factors of postoperative cognitive dysfunction after general anesthesia

Objective To observe the related factors of postoperative cognitive dysfunction in patients with non-cardiac surgery after general anesthesia. Method 267 non-cardiac surgery patients under general anesthesia were included in this study. The patients with POCD were assigned to PD group and those without POCD were served as NPD group. Perioperative information of the patients were recorded. Logistic regression was used in the statistical analysis to the occurrence of postoperative cognitive disorder before and after operation. Results Postoperative cognitive disorder was related to age, ASA grade, smoking history, amount of bleeding, premedication, length of operation time, blood transfusion, dosage of remifentanil, dosage of isoflurane, the hypotension of intraoperative period, the hypertension of postoperative period, high VAS scores. Conclusion The patients age, length of operation time, the hypotension of intraoperative and the VAS score are the risk factors of postoperative cognitive disorder.