老年患者腰椎术后谵妄发病率及相关因素分析

目的]对老年患者腰椎术后谵妄的发病率及相关因素进行分析.方法]回顾性分析2009年1月～2011年6月在本院因腰椎退行性疾病接受手术的114例患者(≥70岁)的病例资料,将术后谵妄发病与既往病史、手术时间、术中输血、输血量、融合节段数以及实验室数据等因素进行相关性研究.结果]腰椎术后共有13例患者出现谵妄,发病率为11.4％,既往有呼吸系统疾病的患者术后谵妄发病率较高(P=0.043),与对照组相比,谵妄组患者术后血红蛋白(P＜0.001)、术前/术后红细胞压积(P=0.013/0.005)及术后白蛋白(P =0.002)均偏低.结论]术后谵妄高发于老年患者中既往有呼吸系统疾病的患者,同时术后血红蛋白、红细胞压积、白蛋白偏低与术后谵妄发病有明显的相关性.

Incidence and related factors of postoperative delirium in lumbar spine surgeries of older patients

Objective]To analyze the incidence and related factors of postoperative delirium in older patients after lumbar spine surgery. Methods]Total 114 patients over 70 years who underwent lumbar operative for degenerative lumbar disease from January 2009 to April 2010 were selected.We analyzed the relation between postoperative delirium and such factors as operative time,intraoperative blood loss and transfusion,comorbidity and laboratory data. Results]Postoperative delirium were found in 13 patients(11.4%).There were significant relationships between postoperative delirium and comorbidity such as pulmonary diseases and hemoglobin(P<0.001),hematocrit(P<0.05) levels and albumin level after surgery was significantly lower than in control group(P=0.002).Oswestry disability index was improved from 51.7% to 22.6% in delirium group and from 49.6% to 23.9% in control group.Hospitalization period was significantly longer in delirium group. Conclusion]Postoperative delirium is of great concern in older patients.History of pulmonary diseases,and low hemoglobin,hematocrit and albumin levels after surgery are significantly related factors for delirium.