CAJ | 학술논문

目的筛选全麻老年患者术后认知功能障碍(POCD)的危险因素.方法择期全麻下行胸部或腹部手术的老年患者300例,年龄65～80岁,采用全凭静脉麻醉.根据术后3d是否发生认知功能障碍,将患者分为非POCD组和POCD组.记录患者一般资料及术前空腹血糖、糖化血红蛋白、血脂及血压.将组间差异有统计学意义的因素进行logistic回归分析,筛选POCD的危险因素.结果 98例患者发生POCD,发生率为32.7％.logistic回归分析结果显示:高龄、糖尿病和高血压是POCD的独立危险因素(P＜0.05).结论高龄、糖尿病和高血压是全麻老年患者POCD的独立危险因素.
목적 사선전마노년환자술후인지공능장애(POCD)적위험인소.방법 택기전마하행흉부혹복부수술적노년환자300례,년령65～80세,채용전빙정맥마취.근거술후3d시부발생인지공능장애,장환자분위비POCD조화POCD조.기록환자일반자료급술전공복혈당、당화혈홍단백、혈지급혈압.장조간차이유통계학의의적인소진행logistic회귀분석,사선POCD적위험인소.결과 98례환자발생POCD,발생솔위32.7％.logistic회귀분석결과현시:고령、당뇨병화고혈압시POCD적독립위험인소(P＜0.05).결론 고령、당뇨병화고혈압시전마노년환자POCD적독립위험인소.
Objective To identify the risk factors for postoperative cognitive dysfunction (POCD).in the elderly patients requiring general anesthesia.Methods Three hundred elderly patients,aged 65-80 yr,scheduled for thoracic or abdominal surgery under general anesthesia,were enrolled in this study.Cognitive function was assessed by Mini-Mental State Examination (MMSE) at 1 day before operation and 3 days after operation.The patients were diagnosed as having POCD if MMSE ＜ 21.The patients were assigned into POCD and non-POCD group.The general data,fasting plasma glucose,glycosylated hemoglobin (HbAlc) and blood pressure were measured.If there was no significant difference between the 2 groups,the factor was analyzed using logistic regression to select the risk factor for the incidence of POCD.Results Ninety-eight patients developed POCD (32.7 ％).Logistic regression model showed that older age,diabetes and hypertension were independent risk factors for POCD (P ＜ 0.05).Conclusion Older age,diabetes and hypertension are independent risk factors for POCD in the elderly patients requiring general anesthesia.