老年认知功能量表对老年下肢骨科手术患者POCD的评价

Assessment of POCD in Elderly Patients on Lower Limb Surgery with the Scale of Elderly Congitive Function

目的探讨老年认知功能量表(the scale of elderly congitive fuction,SECF)对老年下肢骨科手术患者术后认知功能障碍(postoperative cognitive dysfunction,POCD)的评价效果。方法择期行下肢骨科手术的老年患者84例,于术前1d,术后1d、3d以及术后7d采用简易智能状态量表(mini-mentalstateexamination,MMSE)以及SECF量表对认知功能进行测定。结果应用MMSE时,POCD在术后1d、3d以及术后7d的发生率分别为34.52%、28.57%以及19.04%;应用SECF评价时相应发生率则为36.90%、30.95%以及20.24%;两种方法对POCD的检出率无统计学差异;两种方法在术后3d以及术后7d对POCD的评估效果是一致的,Kappa值分别为0.7732和0.8115(P<0.05)。结论 SECF量表具有和MMSE一致的评价效果,并且消除了年龄和受教育因素对老年患者认知功能的影响,在对老年患者POCD的评价中有一定的临床应用价值。

Objective To explore the application of the scale of elderly congitive fimction （SECF） on postoperative cognitive dysfunction （POCD） in the elderly patients of lower limb surgery. Methods The SECF and mini-mental state examination （MMSE） were performed preoprativly on day 1, and postoprativly on day 1, day 3 and day 7 upon 84 elderly patients undergoing lower limb surgery. Results The incidence rate of POCD was 34.52% on postoperativ day 1 by use of MMSE, 28.57% on day 3 and 19.04% on day 7; the corresponding data in SECF were 36.90%, 30.95% and 20.24% respectively. Two methods were consistent for evaluation of POCD on day 3 and day 7, Kappa was 0,7732 and 0,8115 （P〈0.05）. Conclusions The SECF is consistent with MMSE for evaluation of POCD. It eliminates the influence of age and education on congnative in elderly patients and provides an effective and practical way to assess POCD.