CAJ | 학술논문

目的筛选老年患者肠癌切除术后早期认知功能障碍(POCD)的危险因素.方法择期拟行肠癌切除术老年患者120例,年龄≥65岁,性别不限,ASA分级Ⅱ或Ⅲ级.根据患者术后第7天是否发生POCD,将其分为POCD组和非POCD组.记录患者年龄、体重、性别、受教育程度、肿瘤部位、TNM分期、合并疾病、术前中医证型、术前ld、术后l、3、7d的MMSE评分、麻醉时间、苏醒时间、术中出血量及出现低血压次数.采用logistic回归分析法筛选POCD的危险因素.结果术后35例患者发生POCD,发生率为29.2％.Logistic回归分析结果显示:年龄、受教育程度、肿瘤部位及术中出现低血压次数为老年患者肠癌切除术后发生POCD的危险因素(P＜0.05).结论年龄、受教育程度、肿瘤部位和术中出现低血压次数是老年患者肠癌切除术后早期发生POCD的危险因素.
목적 사선노년환자장암절제술후조기인지공능장애(POCD)적위험인소.방법 택기의행장암절제술노년환자120례,년령≥65세,성별불한,ASA분급Ⅱ혹Ⅲ급.근거환자술후제7천시부발생POCD,장기분위POCD조화비POCD조.기록환자년령、체중、성별、수교육정도、종류부위、TNM분기、합병질병、술전중의증형、술전ld、술후l、3、7d적MMSE평분、마취시간、소성시간、술중출혈량급출현저혈압차수.채용logistic회귀분석법사선POCD적위험인소.결과 술후35례환자발생POCD,발생솔위29.2％.Logistic회귀분석결과현시:년령、수교육정도、종류부위급술중출현저혈압차수위노년환자장암절제술후발생POCD적위험인소(P＜0.05).결론 년령、수교육정도、종류부위화술중출현저혈압차수시노년환자장암절제술후조기발생POCD적위험인소.
Objective To investigate the risk factors for early postoperative cognitive dysfunction (POCD) in elderly patients after colorectal cancer surgery.Methods One hunderd and twenty ASA Ⅱ or Ⅲ patients aged ≥ 65 yr undergoing colorectal cancer surgery were divided into POCD group and non-POCD group according to the results of the Mini-Mental State examination (MMSE) at 7th day after operation.Age,weight,sex,the educational level,anatomical location of the tumor,TNM stages,complications,preoperative TCM syndrome type,duration of anesthesia,emergence time,the blood loss during opertion and the number of intraoperative hypotension were recorded.The cognitive function was assessed at 1 d before operation and at 1,3,7 d after operation using MMSE.The risk factors for POCD were analyzed by multivariate logistic regression analysis.Results The incidence of POCD was 29.2 ％.Logistic regression analysis results indicated that age,the educational level,anatomical location of the tumor and the number of intraoperative hypotension were the risk factors for POCD( P ＜ 0.05).Conclusion Age,the educational level,anatomical location of the tumor and the number of intraoperative hypotension are risk factors for POCD in elderly patients after colorectal cancer surgery.