全麻下血管化游离皮瓣修复术后患者谵妄的危险因素

目的 筛选全麻下血管化游离皮瓣修复术后患者谵妄的危险因素.方法 择期行血管化游离皮瓣修复手术的患者216例,年龄18～80岁,根据术后5d内是否发生谵妄分为术后谵妄组和非术后谵妄组.可能的危险因素进行组间比较后,将差异有统计学意义的因素进行logistic回归分析,筛选发生术后谵妄的危险因素.结果 logistic回归分析结果显示,酗酒、术后睡眠紊乱和高龄是术后谵妄的独立危险因素(P<0.05),相对危险度依次为17.066,5.647和1.047.结论 高龄、酗酒史和术后睡眠紊乱是全麻下血管化游离皮瓣修复术后患者谵妄的危险因素.

Risk factors for postoperative delirium in patients after vascular free flap reconstruction performed under general anesthesia

Objective To investigate the risk factors for postoperative delirium in patients after vascular free flap reconstruction performed under general anesthesia.Methods Two hundred and sixteen ASA Ⅰ-Ⅲ patients aged 18-80 yr undergoing vascular free flap reconstruction surgery were enrolled in this study.Patient characteristics before and during operation were recorded.The patients were followed up for 5 days after operation.Their level of consciousness,severity of pain and sleep quality were evaluated daily.The patients were divided into 2 groups according to the occurrence of delirium during the 5 days after operation:delirium group and non-delirium group.The method of CAM-ICU was reed in the diagnosis of postoperative delirium.Multivariate logistic regression was used to analyze the risk factors for postoperative delirium.Results logistic regression analysis showed that old age,history of alcohol abuse and sleep diacrder after operation were risk factors for delirium developed after free flap surgery.Conclusion Old age,history of alcohol abuse and sleep disorder after operation were the risk factors for postoperative delirium in patients after vascular free flap reconstruction performed under general anesthesia.