主动脉弓手术后并发谵妄的临床分析

Clinical analysis of postoperative delirium following aortic arch operation

目的:分析主动脉弓手术后谵妄的发生率和危险因素。方法:回顾分析143例主动脉弓手术后谵妄发生率,按有无谵妄症状分成2组,对其谵妄的可能危险因素做统计学分析。结果:3例患者术后早期因心肺功能衰竭死亡外,谵妄的发生率为29.3%(41/140例)。术后谵妄的危险因素包括:术前高血压病、脑血管疾病、糖尿病、术中低脑氧饱和度、体外循环(CPB)>200 min、术中最低收缩压、最低血压持续时间、术后发热、输血量>3 000 ml。结论:主动脉弓术后谵妄发生率为29.3%,术中最低收缩压、最低血压持续时间及CPB>200 min、术中脑氧饱和度<40%是谵妄发生的独立危险因素。

AIM： To observe the incidence,risk factors and prevention methods of delirium after aortic arch operation.METHODS： The incidence of delirium in 143 patients who received aortic arch surgery was retrospectively analyzed.Patients were divided into two groups according to occurrence or no occurrence of postoperative delirium.Possible delirium-causing risk factors were analyzed.RESULTS： Except for early postoperative death due to cardiac and pulmonary failure in three patients,the incidence of delirium was 29.3%（41/140）.Risk factors for postoperative delirium included 1） preoperative diseases such as hypertension,cerebrovascular diseases and diabetes mellitus;2） lower cerebral oxygen saturation,cardiopulmonary bypass（CPB）200 min,minimum systolic blood pressure and duration of minimum blood pressure during operation,and 3） postoperative fever and blood transfusion volume 3 000 ml.CONCLUSION： Minimum systolic blood pressure and duration of minimum blood pressure,CPB200 min and cerebral oxygen saturation 40% during operation are independent risk factors for the occurrence of delirium.