腹主动脉瘤术后谵妄状态临床分析

Postoperative Delirium in the Surgical Treatment of Abdominal Aortic Aneurysm

【目的】探讨腹主动脉术后谵妄发生的病因、预防和治疗。【方法】对75例进行外科治疗的腹主动脉瘤患者进行回顾性分析。【结果】术后发生谵妄12例,腔内隔绝术后发病4例(4/33),人工血管置换术后发病8例(8/42);谵妄组合并其他全身性并发症8例(8/12),非谵妄组合并其他全身并发症9例(9/63);谵妄组病死率16.7%(2/12),非谵妄组病死率0%。【结论】腹主动脉瘤术后谵妄状态是一种严重并发症,是增加全身并发症和死亡率的重要原因,人工血管置换术后发病率较腔内隔绝术后的发病率高,心理、药物和护理干预是减少发病率和改善预后的重要方法。

[Objective]To research the etiology, prevention and treatment of postoperative delirium for abdominal aortic aneurysm. [Methods]Seventy five cases of abdominal aortic aneurysm received surgical intervention were retrospectively analyzed. [Results]The incidence of postoperative delirium was 16%（ 12/75 ）. Four cases were occurred after endovascular exclusion, and 8 cases occurred after vascular prosthesis replacement. Eight patients with postoperative delirium endured systemic complication, and 9 cases without postoperative delirium endured systemic complication. The mortality of patients with postoperative delirium was 16.7%, while that of patient without postoperative delirium was 0. [Conclusion]The postoperative delirium is the most severe complication, it could increase the incidence of systemic complication and mortality. Psychological, medical intervention and nursing care are important ways to reduce its incidence and improvement the prognosis.