现代医药卫生
現代醫藥衛生
현대의약위생
MODERN MEDICINE HEALTH
2014年
12期
1781-1782,1784
,共3页
精神障碍%手术后期间%老年人%骨科术后%影响因素
精神障礙%手術後期間%老年人%骨科術後%影響因素
정신장애%수술후기간%노년인%골과술후%영향인소
Mental disorders%Postoperative period%Aged%Orthopedic surgery%Influencing factors
目的：探讨老年骨科患者术后精神障碍的影响因素及临床特点。方法选取该院2010年10月至2013年8月收治的120例行骨科手术老年患者，对术后发生急性精神障碍（A组，n=15）及未发生急性精神障碍（B组，n=105）患者的临床资料进行分析，比较两组患者基础病情、麻醉方式、术中低氧血症及手术时间等因素对术后精神障碍的影响。结果120例患者中共15例发生术后急性精神障碍，发生率为12.5%。A组冠心病、高血压、亚临床甲状腺功能减低患病率高于B组，差异均有统计学意义（P＜0.05）。A组硬膜外麻醉患者术后精神障碍发生率[6.67%（2/30）]显著低于全身麻醉患者[14.44%（13/90）]，差异有统计学意义（P<0.05）；A组患者与B组比较，围术期出血量显著增加，血清钠、血清钙血细胞比容及术后血红蛋白显著下降，且电解质失衡，差异均有统计学意义（P<0.05）；两组患者血清钾血细胞比容、手术时间比较，差异无统计学意义（P>0.05）。结论临床上应高度重视老年患者术后精神障碍的发生，实施预见性干预措施可有效预防术后精神障碍的发生或避免其导致的不良后果。
目的：探討老年骨科患者術後精神障礙的影響因素及臨床特點。方法選取該院2010年10月至2013年8月收治的120例行骨科手術老年患者，對術後髮生急性精神障礙（A組，n=15）及未髮生急性精神障礙（B組，n=105）患者的臨床資料進行分析，比較兩組患者基礎病情、痳醉方式、術中低氧血癥及手術時間等因素對術後精神障礙的影響。結果120例患者中共15例髮生術後急性精神障礙，髮生率為12.5%。A組冠心病、高血壓、亞臨床甲狀腺功能減低患病率高于B組，差異均有統計學意義（P＜0.05）。A組硬膜外痳醉患者術後精神障礙髮生率[6.67%（2/30）]顯著低于全身痳醉患者[14.44%（13/90）]，差異有統計學意義（P<0.05）；A組患者與B組比較，圍術期齣血量顯著增加，血清鈉、血清鈣血細胞比容及術後血紅蛋白顯著下降，且電解質失衡，差異均有統計學意義（P<0.05）；兩組患者血清鉀血細胞比容、手術時間比較，差異無統計學意義（P>0.05）。結論臨床上應高度重視老年患者術後精神障礙的髮生，實施預見性榦預措施可有效預防術後精神障礙的髮生或避免其導緻的不良後果。
목적：탐토노년골과환자술후정신장애적영향인소급림상특점。방법선취해원2010년10월지2013년8월수치적120례행골과수술노년환자，대술후발생급성정신장애（A조，n=15）급미발생급성정신장애（B조，n=105）환자적림상자료진행분석，비교량조환자기출병정、마취방식、술중저양혈증급수술시간등인소대술후정신장애적영향。결과120례환자중공15례발생술후급성정신장애，발생솔위12.5%。A조관심병、고혈압、아림상갑상선공능감저환병솔고우B조，차이균유통계학의의（P＜0.05）。A조경막외마취환자술후정신장애발생솔[6.67%（2/30）]현저저우전신마취환자[14.44%（13/90）]，차이유통계학의의（P<0.05）；A조환자여B조비교，위술기출혈량현저증가，혈청납、혈청개혈세포비용급술후혈홍단백현저하강，차전해질실형，차이균유통계학의의（P<0.05）；량조환자혈청갑혈세포비용、수술시간비교，차이무통계학의의（P>0.05）。결론림상상응고도중시노년환자술후정신장애적발생，실시예견성간예조시가유효예방술후정신장애적발생혹피면기도치적불량후과。
Objective To investigate the influencing factors and clinical characteristics of postoperative delirium in the elderly with bone pain. Methods Totally 120 patients with orthopedic surgery received in the hospital from October 2010 to Au-gust 2013 were selected and analyzed on the clinical data of the patients with postoperative mental disorder (group A,n=15) and without postoperative delirium(group B,n=105). The influences of anesthesia, intra-operative hypoxemia and operation time on postoperative delirium in the two groups were compared. Results Among the 120 patients,15 had postoperative acute mental disorder with the incidence rate of 12.5%. The incidence rate of coronary heart disease ,high blood pressure and hypothyroidism of group A was higher than that of group B,which had statistical difference(P<0.05);The incidence rate of postoperative mental dis-order of the patients with epidural anesthesia[6.67%(2/30)] was lower than those with general anesthesia [14.44%(13/90)]. The difference was statically significant(P<0.05);Compared with group B,the bleeding amount during the perioperative period in-creased,while the serum natrium and serum calcium hematocrit as well as hemoglobin fell with electrolyte imbalance ,which had statistical difference(P<0.05);The comparison of serum potassium hematocrit and operation time had no statistically significant difference(P<0.05). Conclusion Much attention should be paid on postoperative delirium in the elderly in the clinic ,predictable intervention measures could be effective in preventing the occurrence of postoperative delirium or avoiding adverse consequences.
