摘要
目的分析老年病人脊柱外科手术后发生精神障碍的风险因素。方法对2011年1月至2016年6月于我院进行脊柱外科手术的348例老年病人的临床资料进行回顾性分析,其中男164例,女184例;年龄为62~93岁,平均年龄为(71.02±5.31)岁。收集病人的性别、年龄、手术时间、术中出血量、是否合并其他系统疾病及是否发生术后精神障碍等资料。结果 348例病人中有83例(23.85%)发生术后精神障碍,出现精神障碍的病人与未出现精神障碍病人的年龄、手术时间、术中出血量及合并症情况的差异均有统计学意义(P均<0.05)。病人年龄≥80岁(OR=1.260,P=0.004)、手术时间>90 min(OR=4.477,P<0.0001)、术中出血量≥400 ml(OR=4.292,P=0.005)、合并原发性高血压(OR=2.422,P=0.002)、合并糖尿病(OR=2.757,P=0.027)、合并脑血管病变(OR=14.510,P=0.037)是脊柱外科手术病人术后发生精神障碍疾病的危险因素。结论年龄过大、手术时间过长、术中出血量大及合并症(原发性高血压、糖尿病、脑血管病变)是老年病人脊柱外科手术后发生精神障碍的危险因素,应术前积极治疗合并症,缩短手术时间,控制术中出血量以避免术后发生精神障碍。
Objective To explore the risk factors of mental disorders after spinal surgery in elderlypatients.Methods 348 elderly patients undergoing spinal surgery from January 2011 to June 2016 in ourhospital were analyzed retrospectively,with 164 males and 184 females,aged 62-93 years,with an average ageof(71.02 ± 5.31) years.Sex,age,operation time,intraoperative blood loss,dosage of narcotic drugs,othersystemic diseases and postoperative mental disorders of the patients were recorded.Results There were 83cases(23.85%) of postoperative mental disorders in 348 patients.There was significant difference in age,operation time,intraoperative blood loss and complications between the patients with and without postoperativemental disorders(P<0.05 for all).Age ≥80 years(OR=1.260,P=0.004),the operation time >90 min(OR=4.477,P<0.0001),the intraoperative blood loss ≥400 ml(OR=4.292,P=0.005),concomitant hypertension(OR=2.422,P=0.002),concomitant diabetes mellitus(OR=2.757,P=0.027),and concomitant cerebrovasculardisease(OR=14.510,P=0.037) were the risk factors of mental disorders after operation.Conclusion Age,operation time,intraoperative blood loss and complications(primary hypertension,diabetes mellitus,cerebrovascular diseases) are independent factors of mental disorders in elderly patients after spinal surgery.We should actively treat the complications,shorten the operation time,and control the intraoperative blood lossso as to avoid the occurrence of postoperative mental disorders.
出处
《骨科》
CAS
2017年第3期203-206,共4页
ORTHOPAEDICS
关键词
脊柱
外科手术
老年人
精神障碍
危险因素
Spine
Surgical procedures
Aged
Mental disorders
Risk factors
