老年食管癌根治术患者术后谵妄的危险因素分析

Analysis of risk factors for postoperative delirium in elderly patients undergoing radical resection of esophageal cancer

中文关键词: 老年  食管癌  食管癌根治术  术后谵妄  危险因素

英文关键词: elderly  esophageal cancer  radical resection of esophageal cancer  postoperative delirium  risk factor

中文摘要:

      目的 探讨老年食管癌根治术患者术后谵妄(POD)的危险因素.方法 回顾性分析2020年9月 2023年9月于南通市肿瘤医院行食管癌根治术的76例老年患者的临床资料,根据是否发生POD分为POD组(16例)和非POD组(60例).对比POD组和非POD组的临床资料,采用二元Logistic回归方法分析老年食管癌根治术患者发生POD的危险因素.结果 2组性别、年龄、BMI、ASA分级、高血压史、糖尿病史、冠心病史、病变位置、手术时间、术中出血量、最低血红蛋白水平、住院时间指标值差异均无统计学意义(P＞0.05);与非POD组相比,POD组在合并焦虑症、合并睡眠障碍、营养不良、预防性使用相关药物、术后疼痛评分≥4分、术后阿片类镇痛药物使用、合并低氧血症占比更高,入住ICU时间更长,差异均有统计学意义(P＜0.05);二元Logistic回归分析结果显示,未预防性使用相关药物、术后疼痛评分≥4分、合并睡眠障碍、合并低氧血症为老年食管癌根治术患者发生POD的独立危险因素(P＜0.05).结论 食管癌根治术老年患者POD的发生率较高,未预防性使用相关药物、术后疼痛评分≥4分、合并睡眠障碍、合并低氧血症可能是老年食管癌根治术患者发生POD的独立危险因素.

英文摘要:

      Objective To explore the risk factors for postoperative delirium(POD)in elderly patients undergoing radi-cal resection of esophageal cancer.Methods A retrospective analysis was performed on the clinical data of 76 elderly patients who underwent radical resection of esophageal cancer in Tumor Hospital of Nantong City between September 2020 and Septem-ber 2023.According to presence or absence of POD,they were divided into POD group(16 cases)and non-POD group(60 cases).The clinical data of the two groups were compared.The risk factors for POD were analyzed by binary Logistic regres-sion analysis.Results There were no statistically significant differences in gender,age,BMI,ASA grade,history of hyper-tension,history of diabetes,history of coronary heart disease,location of lesion,operation time,intraoperative blood loss,minimum hemoglobin level and hospital stay between the two groups(P＞0.05).Compared with the non-POD group,the POD group had a higher proportion of patients with anxiety,sleep disorder,malnutrition,preventive use of related drugs,post-operative pain score≥4 points,postoperative use of opioid analgesics and hypoxemia,and a longer stay in ICU,with statistical significance(P＜0.05).The results of binary Logistic regression analysis showed that no preventive use of relevant drugs,postoperative pain score≥ 4 points,sleep disorders,and hypoxemia were independent risk factors for POD in elderly patients undergoing radical resection of esophageal cancer(P＜0.05).Conclusion The incidence of POD is high in elderly patients undergoing radical resection of esophageal cancer.No preventive use of related drugs,postoperative pain score≥4 points,sleep disorders and hypoxemia are independent risk factors for POD in these patients.