全凭静脉麻醉下脊柱手术患者术后谵妄的危险因素

Risk factors for postoperative delirium in patients undergoing spine operation under total intravenous anesthesia

目的 筛选全凭静脉麻醉下脊柱手术患者发生术后谵妄的危险因素.方法 择期行脊柱手术患者200例,年龄18～70岁,根据术后3 d内是否发生谵妄分为术后谵妄组和非术后谵妄组.可疑危险因素进行组间比较后,将差异有统计学意义的因素进行logistic回归分析,筛选发生术后谵妄的危险因素.结果 39例患者术后发生谵妄,发生率为19.5%.logistic回归分析结果显示,年龄、术中失血量、经常饮酒是发生术后谵妄的独立危险因素（P＜0.05）.相对危险度依次为1.882、0.999、1.715.结论 老龄、术中大量失血、长期饮酒是全凭静脉麻醉下脊柱手术患者发生术后谵妄的危险因素.

Objective To investigate the risk factors for postoperative delirium in patients undergoing spine operation under total intravenous anesthesia. Methods Two hundred patients undergoing elective spine operation were included in this study. Patients＇ perioperative informations were recorded. The diagnosis of delirium was based on Confusion Assessment Method （CAM）. The patients were divided into 2 groups according to the occurrence of delirium within 3 days after operation： postoperative delirium group and no postoperative delirium group. Multivariate logistic regression was used to analyze the risk factors for postoperative delirium. Results Postoperative delirium developed in 39 patients during the first three postoperative days. The incidence of postoperative delirium was 19.5%. The logistic stepwise regression analysis indicated that the risk factors for delirium included age, intraoperative blood loss and alcohol abuse. Conclusion Age, large amount of intraoperative blood loss and alcohol abuse are risk factors for postoperative delirium in patients undergoing spine operation under total intravenous anesthesia.