老年结直肠癌患者术后发生谵妄的危险因素和临床治疗方法及效果

Postoperative delirium in elderly patients with colorectal cancer: Risk factors and treatment

目的:探讨老年结直肠癌患者术后发生谵妄的危险因素和临床治疗方法及效果.方法:采取回顾性方法分析对2012-01/2014-06河北医科大学第四医院220例老年结直肠癌患者临床资料进行分析,采取ICU谵妄诊断的意识状态评估法进行观察,将其分为谵妄组和非谵妄组.并且将术后发生谵妄的患者随机分为治疗组与非治疗组,观察治疗效果.结果:18例术后发生谵妄,发生率为8.2%.谵妄组和非谵妄组年龄、术后疼痛视觉模拟评分(visual analogue scale,VAS)评分、合并高血压、合并糖尿病、合并冠心病、手术中出血量>500 m L、手术时间>3 h、术后低氧血症比较差异有统计学意义(t=7.015、5.177;χ2=9.314、8.514、4.272、8.218、6.714、10.371均P<0.05);治疗组与非治疗组术后谵妄缓解率和住院时间比较差异有统计学意义(χ2=11.031,t=9.729,P<0.05).结论:临床中影响老年结直肠癌患者术后发生谵妄的危险因素较多,且给予氟哌利多治疗效果明显.

AIM： To explore the risk factors for postoperative delirium in elderly patients with colorectal cancer and to discuss clinical treatment methods and effects.METHODS： A retrospective analysis was performed of clinical data for 220 elderly patients with colorectal cancer treated by surgery from January 2012 to June 2014. The patients were divided into either a delirium group or a nondelirium group according to the presence of delirium or not. The delirium group was further randomized into a treatment subgroup and a non-treatment subgroup to evaluate the treatment effects. RESULTS： There were 18 cases of postoperative delirium, and the incidence rate was 8.2%. Age, postoperative VAS score, hypertension, diabetes, coronary heart disease, blood loss 〉 500 m L, operative time 〉 3 h, and postoperative hypoxemia differed significantly between the delirium and non-delirium group（t = 7.015, 5.177; χ2 =9.314, 8.514, 4.272, 8.218, 6.714, 10.371, P 〈 0.05）. The rate of remission of postoperative delirium and hospitalization time differed significantly between the treatment subgroup and the nontreatment subgroup（χ2 = 11.031, t = 9.729, P 〈 0.05）. CONCLUSION： There are many risk factors for postoperative delirium in elderly patients with colorectal cancer, and droperidol has a good therapeutic effect in the management of this condition.