CAJ | 학술논문

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.
목적 사선전마하혈관화유리피판수복술후환자섬망적위험인소.방법 택기행혈관화유리피판수복수술적환자216례,년령18～80세,근거술후5d내시부발생섬망분위술후섬망조화비술후섬망조.가능적위험인소진행조간비교후,장차이유통계학의의적인소진행logistic회귀분석,사선발생술후섬망적위험인소.결과 logistic회귀분석결과현시,후주、술후수면문란화고령시술후섬망적독립위험인소(P<0.05),상대위험도의차위17.066,5.647화1.047.결론 고령、후주사화술후수면문란시전마하혈관화유리피판수복술후환자섬망적위험인소.
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.