CAJ | 학술논문

目的：比较三种评判标准对非心脏手术患者术后认知功能障碍(POCD)发生率的评估。方法随机选择非心脏手术患者461例为研究组,同期住院非手术患者244例作为对照组,用MMSE 对两组患者进行术前、术后1 d 及术后3 d 认知功能测试,所得分值分别采用受教育程度法、Z计分法和1个标准差法(1SD 法)对术后认知功能进行评定。结果术后1 d 和3 d,Z 计分法对POCD 的检出率和95%的可信区间最高,受教育程度法最低；术后1 d 和3 d 受教育程度法阳性、Z计分法阴性分别有1例和4例。结论不同的评判标准可使同一组病例 POCD 的发生率显著不同,在对认知功能评判的研究中 Z 计分法更具合理性,可以较大程度地避免了 POCD 的漏诊。
목적：비교삼충평판표준대비심장수술환자술후인지공능장애(POCD)발생솔적평고。방법수궤선택비심장수술환자461례위연구조,동기주원비수술환자244례작위대조조,용MMSE 대량조환자진행술전、술후1 d 급술후3 d 인지공능측시,소득분치분별채용수교육정도법、Z계분법화1개표준차법(1SD 법)대술후인지공능진행평정。결과술후1 d 화3 d,Z 계분법대POCD 적검출솔화95%적가신구간최고,수교육정도법최저；술후1 d 화3 d 수교육정도법양성、Z계분법음성분별유1례화4례。결론불동적평판표준가사동일조병례 POCD 적발생솔현저불동,재대인지공능평판적연구중 Z 계분법경구합이성,가이교대정도지피면료 POCD 적루진。
Objective Compare the three kind of criteria in evaluating the incidences of postop-erative cognitive dysfunction in non-cardiac surgery.Methods Four hundred and sixty one non-cardiac surgery patients were randomly enrolled in this study group and two hundred forty four non-surgery patients as control group.Patients??cognitive state was measured on preoperative and postoperative 1 and 3 d by mini-mental state examination(MMSE).POCD was assessed by patients??education level, one standard deviation and Z-score scale,respectively.Results On the first and third day after sur-gery,Z-score scale assess POCD result showed the highest relevance ratio and 95%CI as well as the lowest education level.The education scale showed the lowest incidence of POCD.Education level criteria was positive on postoperative 1 and 3 day,while one case on postoperative 1 day and four cases on postoperative 3 day were negative by Z-score scale.Conclusion The incidence of POCD in same pa-tients by three kind of criteria are different.The Z-score scale is recommended to evaluate the POCD in order to avoid misdiagnosis.