中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2013年
1期
34-36
,共3页
陈易%魏昌伟%俞一瑾%倪新莉%熊利泽
陳易%魏昌偉%俞一瑾%倪新莉%熊利澤
진역%위창위%유일근%예신리%웅리택
精神运动性激动%麻醉恢复期%认知障碍%手术后并发症
精神運動性激動%痳醉恢複期%認知障礙%手術後併髮癥
정신운동성격동%마취회복기%인지장애%수술후병발증
Psychomotor agitation%Anesthesia recovery period%Cognition disorders%Postoperative complications
目的 评价全麻患者麻醉恢复期躁动与术后认知功能障碍(POCD)的关系.方法 择期全麻手术患者280例,性别不限,年龄18~70岁,体重52 ~ 80 kg,ASA分级Ⅰ或Ⅱ级.于拔除气管导管后15~40 min时采用术后恢复质量评估量表评估麻醉恢复期躁动的发生情况,于术前1d、术后1~7d评估认知功能.根据是否出现POCD将患者分为POCD组和非POCD组.记录患者一般情况、术前合并症及手术类型,将组间差异有统计学意义的因素进行多因素logistic回归分析.结果 术后POCD发生率40.7%.logistic回归分析结果显示:与POCD发生明显相关因素的危险程度从高至低:麻醉恢复期躁动、麻醉时间、年龄.结论 全麻患者麻醉恢复期躁动是POCD发生的独立危险因素之一.
目的 評價全痳患者痳醉恢複期躁動與術後認知功能障礙(POCD)的關繫.方法 擇期全痳手術患者280例,性彆不限,年齡18~70歲,體重52 ~ 80 kg,ASA分級Ⅰ或Ⅱ級.于拔除氣管導管後15~40 min時採用術後恢複質量評估量錶評估痳醉恢複期躁動的髮生情況,于術前1d、術後1~7d評估認知功能.根據是否齣現POCD將患者分為POCD組和非POCD組.記錄患者一般情況、術前閤併癥及手術類型,將組間差異有統計學意義的因素進行多因素logistic迴歸分析.結果 術後POCD髮生率40.7%.logistic迴歸分析結果顯示:與POCD髮生明顯相關因素的危險程度從高至低:痳醉恢複期躁動、痳醉時間、年齡.結論 全痳患者痳醉恢複期躁動是POCD髮生的獨立危險因素之一.
목적 평개전마환자마취회복기조동여술후인지공능장애(POCD)적관계.방법 택기전마수술환자280례,성별불한,년령18~70세,체중52 ~ 80 kg,ASA분급Ⅰ혹Ⅱ급.우발제기관도관후15~40 min시채용술후회복질량평고량표평고마취회복기조동적발생정황,우술전1d、술후1~7d평고인지공능.근거시부출현POCD장환자분위POCD조화비POCD조.기록환자일반정황、술전합병증급수술류형,장조간차이유통계학의의적인소진행다인소logistic회귀분석.결과 술후POCD발생솔40.7%.logistic회귀분석결과현시:여POCD발생명현상관인소적위험정도종고지저:마취회복기조동、마취시간、년령.결론 전마환자마취회복기조동시POCD발생적독립위험인소지일.
Objective To evaluate the relationship between emergence agitation (EA) during recovery from general anesthesia and postoperative cognitive dysfunction (POCD).Methods Two hundred and eighty ASA Ⅰ or Ⅱ patients,aged 18-70 yr,weighing 52-80 kg,undergoing elective surgery,were included.Anesthesia was induced with midazolam,fentanyl,propofol and cisatracurium.The patients were tracheal intubated and mechanically ventilated.Anesthesia was maintained with remifentanil,propofol and cisatracurium.EA was assessed at 15-40 min after extubation by using Post-operative Quality Recovery Scale and the cognitive function was assessed at day 1 before operation and days 1-7 after operation.Patients were divided into POCD or nonPOCD group according to the occurrence of POCD.The general data of patients,preoperative complications and types of surgery were recorded.If there was significant difference between the 2 groups,the factor was analyzed using multi-factor logistic regression to select the risk factor for incidence of POCD.Results The incidence of POCD was 40.7 %.The results of logistic regression analysis showed that the dangerous degree of the risk factors for POCD in order from high to low were emergence agitation,duration of anesthesia and age.Conclusion EA during recovery from general anesthesia is an independent risk factor for POCD.