摘要
目的研究外科ICU中体外循环心脏手术后精神障碍的发生率 ,并分析其相关因素。方法 30 5例体外循环冠脉搭桥和瓣膜手术病人 ,术前统计年龄、性别、合并症及手术种类 ,体外循环期间统计最低红细胞压积及总转流时间 ,术后统计低氧血症、高血糖及电解质紊乱发生情况。术后第 1d起用CAM ICU量表观察病人精神变化。结果 30 5例病人中 ,33例术后发生精神障碍 ,总发生率为 10 .82 %。其中冠脉搭桥术后发生率为 14 .4 3% ,心脏瓣膜术后为 3.85 % ;年龄、术前合并糖尿病、冠脉搭桥手术、体外循环期间红细胞压积与术后精神障碍密切相关。结论冠脉搭桥手术病人术后精神障碍发生率较高 ;高龄、术前合并糖尿病。
Objective To investigate the incidence and correlative factors of postoperative mental disturbances in patients undergoing cardiac surgeries with moderate hypothermia cardiopulmonary bypass in the surgical intensive care unit (SICU). Methods From November 1999 to February 2004, 305 patients undergoing cardiac surgeries in SICU were studied. The incidence of postoperative mental disturbances was investigated and multivariate LOGISTIC regression was used to analyze the correlative factors. Results Postoperative mental disturbances (POMD) occurred in 33 patients of the 305 patients. The overall incidence of POMD was 10.82%, and the incidence of POMD in patients undergoing coronary artery bypass grafting (CABG) and valve surgery was 14.43% and 3.85%, respectively; multivariate LOGISTIC regression showed that age, pre-existing diabetes, CABG, and lower hemocrit during cardiopulmonary bypass (CPB) were significantly correlated to postoperative mental disturbances. Conclusion The incidence of postoperative mental disturbances is higher in the patients undergoing CABG than in whom undergoing valve surgery; aging, pre-existing diabetes, CABG and lower hemotocrit during CPB are the risk factors of POMD in patients undergoing cardiac surgeries.
出处
《上海第二医科大学学报》
CSCD
2004年第11期916-918,共3页
Acta Universitatis Medicinalis Secondae Shanghai
基金
上海市领先专业麻醉学重点学科 (9930 2 7)资助项目
关键词
体外循环
心脏手术
精神障碍
发生率
cardiopulmonary bypass
cardiac surgery
postoperative mental disturbances
incidence
correlative factors
