老年患者术后谵妄的相关因素分析

摘要： 目的 探讨老年患者术后谵妄的相关影响因素， 为其预防和治疗提供参考。方法 手术后发生谵妄者 54 例为观察组， 同期外科手术资料完整无谵妄者 150 例为对照组。比较分析 2 组年龄、 性别、 营养不良、 水电解质紊乱、 术后机械通气、 术后低氧血症、 重症感染以及术后疼痛程度和合并基础疾病的差异， 二分类 Logistic 分析患者术后谵妄的影响因素。记录并分析观察组患者的疾病转归及预后情况。结果 观察组平均年龄高于对照组， 术后低氧血症、 重症感染构成比例高于对照组 （P＜0.05）。高龄、 术后有低氧血症、 重症感染是患者术后发生谵妄的危险因素。观察组 1 例死于肺感染， 1 例死于多脏器功能衰竭， 余 52 例患者出院 3 个月后均好转。结论 高龄、 术后有低氧血症、 重症感染为患者术后谵妄发生的危险因素， 临床术前与术后需要多加注意。

Analysis of related factors of postoperative delirium in elderly patients

Abstract：Objective To explore related influencing factors for postoperative delirium in elderly patients, to provide a reference for the prevention and treatment. Methods Fifty-four patients with delirium after surgery were used as observa⁃ tion group, and a total of 150 subjects with no delirium after surgery during the same period were selected as the control group. Data of age, gender, malnutrition, disorders of water and electrolyte metabolism, postoperative mechanical ventilation, postoperative hypoxemia, severe infection and postoperative pain degree, and the combination of basic diseases were com⁃ pared and analysed between two groups. The binary logistic regression analysis was used to analyse the influencing factors of postoperative delirium. The outcome and prognosis were observed and analyzed in observation group. Results The average age was significantly higher in observation group than that of control group (P＜0.05). The percentages of postoperative hy⁃ poxemia and severe infection were significantly higher in observation group than those of control group (P < 0.05). Patients with higher age, postoperative hypoxemia and severe infection were risk factors for postoperative delirium. In observation group,1 case died of lung infection, 1 case died of multiple organ failure, the remaining 52 patients were improved and dis⁃ charged from hospital after three months. Conclusion For patients with higher age, postoperative hypoxemia and severe in⁃ fection are the risk factors for occurrence of postoperative delirium. More attention should be paid to clinical preoperative and postoperative periods.