经前路颈椎手术患者术后谵妄相关因素研究 (1)
【摘要】 目的：分析经前路颈椎手术患者术后谵妄的发病情况及其围术期相关因素。方法 回顾性分析我院2008年1月一2010年12月423例行颈前路颈椎手术的颈椎病患者的临床资料，包括年龄、吸烟史、饮酒史(>3次/周)、高血压病史、糖尿病病史、冠心病病史、既往手术史、服用安眠药史、术前焦虑、术后镇痛、术后疼痛评分>3分、术后睡眠障碍和术后缺氧的发生情况。将可能与术后发生谵妄的相关因素进行多因素非条件Logistic回归分析。结果 31例患者发生术后谵妄，发生率为7.3% (31/ 423)。经单因素分析，年龄、有无饮酒史、有无高血压病史、有无术前焦虑、有无术后镇痛、术后疼痛评分>3分、有无术后睡眠障碍及有无术后缺氧比较，差异均有统计学意义(P<0.20)；并进行多因素非条件Logistic回归分析显示，年龄[OR=3.724，95%CI(1.451，8.172)，P=0.004]、术后疼痛评分>3分[OR= 4.782，95%CI(1.781，12.513)，P=0.002]、术后睡眠障碍[OR=3.131，95%CI (1.452，8.237)，P=0.003]、术后缺氧[OR=3.430，95%CI (1.107，13.256)，P=0.005]进入回归方程。结论 高龄、术后疼痛评分>3分、术后睡眠障碍、术后缺氧是经前路颈椎手术患者术后发生谵妄的危险因素。
【关键词】 经前路颈椎手术；谵妄；危险因素
Analysis on Relevant Factors of Postoperative Delirium in the patients after anterior cervical spinal operation/ OU Ying.Department of Psychiatry，Affiliated Hospital of Luzhou Medical College，Luzhou 646000，China
【Abstract】 Objective To investigate the prevalence of delirium and perioperative factors after anterior cervical spinal operation.Methods Clinical data (including age， smoking history，drinking history，hypertension history， diabetes history，coronary heart disease history，operation history，history of taking sleeping pills，preoperative anxiety， postoperative analgesia，postoperative Visual Analog Scale (VAS)>3， postoperative sleep disturbance and postoperative ischemia) of 423 cervical spondylisis patients underwent anterior cervical spinal operation in our hospital from January 2008 to November 2010 were retrospectively analyzed. Possible relevant factors for postoperative delirium were analyzed by using multiple factor logistic regression analysis.Results Thirty-one patients had postoperative delirium with an occurrence rate of 7.3%(31/423). According to single factor analysis，age，history of drinking，history of hypertension，preoperative anxiety， postoperative analgesia，postoperative VAS>3，postoperative sleep disorder and postoperative ischemia all showed statistically significant differences (P<0.20).Muhiple factor unconditional Logistic regression analysis showed that age[OR=3.724，95%CI(1.451，8.172)，P=0.004]， postoperative VAS>3 [OR=4.782，95%CI (1.781， 12.513)，P=0.002]， postoperative sleep disturbances [OR=3.131，95%CI (1.452， 8.237)，P=0.003]，postoperative ischemia [OR=3.430，95%CI (1.107， 13.256)，P=0.005] entered the regression equation. Conclusion Postoperative VAS>3，senior age， postoperative sleep disturbances and postoperative ischemia are risk factors for postoperative delirium in the patients after anterior cervical spinal operation., 百拇医药(欧颖 )
【关键词】 经前路颈椎手术；谵妄；危险因素
Analysis on Relevant Factors of Postoperative Delirium in the patients after anterior cervical spinal operation/ OU Ying.Department of Psychiatry，Affiliated Hospital of Luzhou Medical College，Luzhou 646000，China
【Abstract】 Objective To investigate the prevalence of delirium and perioperative factors after anterior cervical spinal operation.Methods Clinical data (including age， smoking history，drinking history，hypertension history， diabetes history，coronary heart disease history，operation history，history of taking sleeping pills，preoperative anxiety， postoperative analgesia，postoperative Visual Analog Scale (VAS)>3， postoperative sleep disturbance and postoperative ischemia) of 423 cervical spondylisis patients underwent anterior cervical spinal operation in our hospital from January 2008 to November 2010 were retrospectively analyzed. Possible relevant factors for postoperative delirium were analyzed by using multiple factor logistic regression analysis.Results Thirty-one patients had postoperative delirium with an occurrence rate of 7.3%(31/423). According to single factor analysis，age，history of drinking，history of hypertension，preoperative anxiety， postoperative analgesia，postoperative VAS>3，postoperative sleep disorder and postoperative ischemia all showed statistically significant differences (P<0.20).Muhiple factor unconditional Logistic regression analysis showed that age[OR=3.724，95%CI(1.451，8.172)，P=0.004]， postoperative VAS>3 [OR=4.782，95%CI (1.781， 12.513)，P=0.002]， postoperative sleep disturbances [OR=3.131，95%CI (1.452， 8.237)，P=0.003]，postoperative ischemia [OR=3.430，95%CI (1.107， 13.256)，P=0.005] entered the regression equation. Conclusion Postoperative VAS>3，senior age， postoperative sleep disturbances and postoperative ischemia are risk factors for postoperative delirium in the patients after anterior cervical spinal operation., 百拇医药(欧颖 )