患者自控静脉镇痛引起老年人术后认知功能障碍的病例对照研究

目的 探讨患者自控静脉镇痛(PCIA)引起老年人术后认知功能障碍(POCD)的可能危险因素. 方法用Mini-Mental-State(MMS)方法测试认知功能,以性别、术式、PCIA总量为匹配条件,对择期行骨科手术65岁以上的全身麻醉患者POCD组95例,未发生POCD组97例进行病例对照研究. 结果单因素分析显示,受教育程度、视觉模拟疼痛评分(VAS)低于5分的例数在两组间差异有统计学意义;多因素分析证实,VAS、受教育程度与PCIA引起POCD显著相关,OR值(95%CI)分别为2.379(1.205～4.698)和0.292(0.157～0.543). 结论 PCIA引起POCD的危险因素为VAS低,而受教育程度高可能是其保护因素.

A case-control study on postoperative cognitive dysfunction induced by patient-controlled intravenous analgesia in elderly patients

Objective To investigate the risk factors for postoperative cognitive dysfunction (POCD)induced by patient-controlled intravenous analgesia(PCIA)in elderly patients. Methods 95 patients with POCD and 97 cognitive normal controls were included in the study. The cases and controls were matched for gender, type of operation and PCIA volume dose. Cognitive function was assessed by Mini-Mental-State test and the relationship between POCD and various factors was analyzed by univariate and multivariate analysis. Results Univariate analysis revealed that the education level and visual analog scale (VAS) score had significant differences between the two groups. Multivariate analysis showed that the VAS score and education level were significantly related to POCD induced by PCIA, with the odds ratios of 2. 379 (95%CI:1.205～4.698) and 0. 292 (95%CI:0.157～0.543), respectively. Conclusions Lower VAS score is an independent risk factor and higher education level seems to be a protective factor for POCD induced by PCIA.