[1]李森磊,孙立,杨先腾,等.老年髋关节置换术后认知功能障碍的危险因素分析[J].中华老年骨科与康复电子杂志,2016,(02):71-75.[doi:10.3877/cma.j.issn.2096-0263.2016.02.002]
　Li Senlei,Sun Li,Yang Xianteng,et al.Risk factors analysis for postoperative cognitive dysfunction in 　elderly patients undergoing hip arthroplasty[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(02):71-75.[doi:10.3877/cma.j.issn.2096-0263.2016.02.002]
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老年髋关节置换术后认知功能障碍的危险因素分析()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2016年02期
页码:
71-75
栏目:
髋部骨折
出版日期:
2016-05-17

文章信息/Info

Title:
Risk factors analysis for postoperative cognitive dysfunction in 　elderly patients undergoing hip arthroplasty
作者:
李森磊; 孙立;  杨先腾; 胡如印; 韩伟; 田家亮; 方开云; 刚绍鹏; 向慧; 顾然; 李春燕; 田晓滨
550002 贵阳，贵州省人民医院骨科，麻醉科，心理门诊，神经内科
Author(s):
Li Senlei;  Sun Li;  Yang Xianteng;  Hu Ruyin;  Tian Jialiang;  Han Wei;  Fang Kaiyun;  Gang Shaopeng;  Gu Ran;  Li Chunyan;  Xiang Hui;  Tian Xiaobin
Department of Orthopedics, Department of Anesthesia, Dpartment of Psychiatrist, Department of Neurology, People’ s Hospital of Guizhou Province, Guiyang 550002, China
关键词:
关节成形术; 置换; 髋; 　老年人; 　认知功能障碍
Keywords:
Arthroplasty;  replacement;  hip; 　Aged; 　Cognition disorders
DOI:
10.3877/cma.j.issn.2096-0263.2016.02.002
摘要:
目的　探讨并分析老年患者髋关节置换术后发生认知功能障碍（POCD）的危险因素及处理对策。方法　回顾性分析2012 年8 月至2014 年1 月收治的符合纳入标准的老年髋部骨折患者293 例，根据是否出现POCD 分组，记录并比较两组患者的年龄、性别、手术时间、内环境情况及术后睡眠状况，采用多因素Logistic 回归分析老年髋部骨折患者POCD 的危险因素，观察术后并发症的情况。结果　单因素分析显示两组患者的年龄（χ2=33.043，P ＜ 0.05）、手术时间（χ2=21.776， P ＜ 0.05）、睡眠质量（χ2=64.722，P ＜ 0.05）、内环境紊乱情况（χ2=32.632，P ＜ 0.05）差异有统计学意义。多因素分析示65 ～ 69 岁和≥ 70 岁组POCD 发生率高于年龄＜ 65 岁组，OR 值为6.434 （95% CI：2.945 ～ 14.059）；手术时间80 ～ 99 min 组和＞ 100 min 组POCD 发生率高于＜ 80 min 组，OR 值为4.241（95% CI：2.383 ～ 7.547）；睡眠紊乱组＞睡眠质量良好组，OR 值为0.103（95% CI：0.040 ～ 0.261）；出现2 种以上内环境紊乱组＞出现一种内环境紊乱组，OR 值为3.586（95% CI：1.517 ～ 11.114）。结论　高龄、睡眠质量差、手术时间长、内环境紊乱是老年髋部骨折发生 POCD 的危险因素。
Abstract:
Objective　To study the reason and treatment methods of cognitive dysfunction after hip arthroplasty in elderly patients (postoperative cognitive dysfunction, POCD).Methods　Two hundred and ninety-three elderly cases with hip fracture were reviewed from August 2012 to Juanury 2014. There were two groups according to the occurrence of the POCD. The age, operation time, inner environment and postoperative sleep quality were analyzed. The logistic multiveariate regression analysis were conducted to analyze the risk factors of POCD in elderly patients with hip fracture. Results　The single factor analysis indicated age (χ2=33.043, P<0.05), operation time (χ2=21.776, P<0.05), sleep quality (χ2=64.722, P<0.05) and inner environment（χ2=32.632, P<0.05）, the differences were statistically significant. The logistic multiveariate regression analysis showed the POCD incidence rates of 65-69 age and 70 age-above groups were higher than the 65 age-below group, and OR was 6.434 (95% CI: 2.945- 14.059); the POCD incidence rates of groups which had 80-99 minutes and 100-minutes-above operation time were higher than the group which had 80-minutes-below operation time, and OR was 4.241 (95% CI:2.383-7.547); the incidence rates of the poor sleep quality group were higher than the good sleep quality group, and the OR was 0.103 (95% CI: 0.040-0.261); the incidence rates of two or more innner environment disturbances group were higher than the sigle innner environment disturbance group, and OR was 3.586 (95% CI: 1.517-11.114). Conclusion　The advanced age, long operation time and poor sleep quality were important risk factors of POCD in elderly patients with hip fracture.

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备注/Memo

备注/Memo:
贵州省科技计划（黔科合SY字【2015】3044）
更新日期/Last Update: 2016-05-17