CAJ | 학술논문

目的：分析腹腔镜胃肠手术患者发生术后认知功能障碍（postoperative cognitive dys-function，POCD）的危险因素。方法腹腔镜胃肠手术患者85例（腹腔镜组），开腹胃肠手术患者80例（开腹组），分别于术前1天、术后第1天和第7天进行简易智力状态检查（Mini Mental State Examination，MMSE），并进行 Logistic 多因素回归分析。结果腹腔镜组和开腹组患者术后第1天POCD 的发生率分别为24.71％和27.50％，第7天分别为18.82％和21.25％，两组在两个时间点分别比较，差异均无统计学意义（P ﹥0.05）。Logistic 回归分析显示，腹腔镜手术中，年龄、气腹时间、麻醉时间与 POCD 的发生呈正相关。结论腹腔镜和开腹胃肠手术后 POCD 的发生率比较差异无统计学意义，患者的年龄、气腹时间以及麻醉时间是腹腔镜患者术后 POCD 的危险因素。
목적：분석복강경위장수술환자발생술후인지공능장애（postoperative cognitive dys-function，POCD）적위험인소。방법복강경위장수술환자85례（복강경조），개복위장수술환자80례（개복조），분별우술전1천、술후제1천화제7천진행간역지력상태검사（Mini Mental State Examination，MMSE），병진행 Logistic 다인소회귀분석。결과복강경조화개복조환자술후제1천POCD 적발생솔분별위24.71％화27.50％，제7천분별위18.82％화21.25％，량조재량개시간점분별비교，차이균무통계학의의（P ﹥0.05）。Logistic 회귀분석현시，복강경수술중，년령、기복시간、마취시간여 POCD 적발생정정상관。결론복강경화개복위장수술후 POCD 적발생솔비교차이무통계학의의，환자적년령、기복시간이급마취시간시복강경환자술후 POCD 적위험인소。
Objective To analyze the potential risk factors of postoperative cognitive dysfunction (POCD)in patients undergoing gastrointestinal laparoscopy. Method There were 85 patients undergoing gastrointestinal laparoscopy(GL)and 80 patients undergoing open surgery(OS). Mini mental state ex-amination was performed on the day before operation and the 1st and 7th day after operation. The scores were evaluated by multi-factor logistic regression analysis. Result The incidences of POCD in GL and OS patients on the 1st day after surgery were 24. 71% and 27. 50% ,while it was 18. 82% and 21. 25% on the 7th day after surgery(P ﹥ 0. 05). Logistic regression analysis revealed that age,duration of CO2 pneumoperitoneum and duration of anesthesia were positively related to the occurrence of POCD. Conclu-sion Thereˊs no significant difference between the incidences of POCD in OS and GL patients. Age,du-ration of CO2 pneumoperitoneum and anesthesia are the risk factors of POCD in patients undergoing GL.