北京医学
北京醫學
북경의학
BEIJING MEDICAL JOURNAL
2014年
8期
669-671
,共3页
老年%膝关节置换术%术后认知功能障碍%蒙特利尔认知评价量表%简易精神状态检查量表
老年%膝關節置換術%術後認知功能障礙%矇特利爾認知評價量錶%簡易精神狀態檢查量錶
노년%슬관절치환술%술후인지공능장애%몽특리이인지평개량표%간역정신상태검사량표
Aged%Knee arthroplasty%Postoperative cognitive dysfunction(POCD)%Montreal cognitive assess-ment(MoCA)%Mini-mental state examination(MMSE)
目的：探讨蒙特利尔认知评价量表（Montreal cognitive assessment, MoCA）对老年患者膝关节置换术后认知功能障碍（postoperative cognitive dysfunction, POCD）的评价效果。方法择期全麻下行单侧全膝关节置换术的老年患者60例，年龄≥65岁，ASAⅠ～Ⅱ级。于术前1 d、术后1 d、术后7 d采用简易精神状态检查量表（mini-mental state examination, MMSE）及MoCA量表对患者的认知功能进行评估。结果术后1 d POCD的发生率，应用MMSE量表为31.0%、应用MoCA量表为32.8%；术后7 d POCD的发生率，MMSE量表为17.2%、MoCA量表为24.1%；两种量表在术后1 d、7 d对POCD的检出率差异均无统计学意义（P>0.05）。术后1 d与术后7 d两种方法一致性检验的Kappa值分别为0.802和0.583（P均<0.01）。结论 MoCA量表与MMSE量表对评估POCD具有良好的一致性，MoCA量表对老年患者POCD的评价具有一定的临床应用价值。
目的：探討矇特利爾認知評價量錶（Montreal cognitive assessment, MoCA）對老年患者膝關節置換術後認知功能障礙（postoperative cognitive dysfunction, POCD）的評價效果。方法擇期全痳下行單側全膝關節置換術的老年患者60例，年齡≥65歲，ASAⅠ～Ⅱ級。于術前1 d、術後1 d、術後7 d採用簡易精神狀態檢查量錶（mini-mental state examination, MMSE）及MoCA量錶對患者的認知功能進行評估。結果術後1 d POCD的髮生率，應用MMSE量錶為31.0%、應用MoCA量錶為32.8%；術後7 d POCD的髮生率，MMSE量錶為17.2%、MoCA量錶為24.1%；兩種量錶在術後1 d、7 d對POCD的檢齣率差異均無統計學意義（P>0.05）。術後1 d與術後7 d兩種方法一緻性檢驗的Kappa值分彆為0.802和0.583（P均<0.01）。結論 MoCA量錶與MMSE量錶對評估POCD具有良好的一緻性，MoCA量錶對老年患者POCD的評價具有一定的臨床應用價值。
목적：탐토몽특리이인지평개량표（Montreal cognitive assessment, MoCA）대노년환자슬관절치환술후인지공능장애（postoperative cognitive dysfunction, POCD）적평개효과。방법택기전마하행단측전슬관절치환술적노년환자60례，년령≥65세，ASAⅠ～Ⅱ급。우술전1 d、술후1 d、술후7 d채용간역정신상태검사량표（mini-mental state examination, MMSE）급MoCA량표대환자적인지공능진행평고。결과술후1 d POCD적발생솔，응용MMSE량표위31.0%、응용MoCA량표위32.8%；술후7 d POCD적발생솔，MMSE량표위17.2%、MoCA량표위24.1%；량충량표재술후1 d、7 d대POCD적검출솔차이균무통계학의의（P>0.05）。술후1 d여술후7 d량충방법일치성검험적Kappa치분별위0.802화0.583（P균<0.01）。결론 MoCA량표여MMSE량표대평고POCD구유량호적일치성，MoCA량표대노년환자POCD적평개구유일정적림상응용개치。
Objective To explore the evaluation value of Montreal cognitive assessment (MoCA) in postoperative cognitive dysfunction of elderly patients with knee arthroplasty. Methods Sixty elderly patients (65 years older), ASAⅠ~Ⅱ, who were underwent knee arthroplasty under general anesthesia were included into this study. The cognitive function of these patients was assessed preoperatively and on the 1st and 7th postoperative day with the mini-mental state examination (MMSE) and MoCA. Results The detection rate of MMSE was 31.0%, while MoCA was 32.8% on the 1st postoperative day (P> 0.05). On the 7th postoperative day, the corresponding data was 17.2% and 24.1%(P> 0.05), respectively. The consistency of both methods for evaluation of POCD on day 1 and day 7 was 0.802 and 0.583 (P< 0.05). Conclusion There is a good consistency for evaluation of POCD between MMSE and MoCA. MoCA has clinical application value for the assessment of elderly patients with POCD.
