术前合并不同疾病对老年患者POCD的影响

THE EFFECT OF PREOPERATIVE COMPLICATIONS ON POSTOPERATIVE COGNITIVE DYSFUNCTION IN ELDERLY PATIENTS

目的探讨术前合并不同疾病对老年患者POCD的影响。方法择期行妇科全麻手术,年龄在65岁以上患者386例,术前记录是否合并冠心病、高血压、糖尿病、慢性肾功能不全、肝功能不全等,术前1天和术后第1天应用简易智力状态检查(Mini-Mental State Examination,MMSE)测试方法评定其认知功能并记录,MMSE评分较术前基础值下降2分认为有认知功能障碍,并据此分为发生POCD组和未发生POCD组。结果发生POCD组中合并冠心病、高血压、糖尿病、慢性肾功能不全患者比例高于未发生POCD组,两组比较差异有统计学意义(p<0.05),但两组合并慢性肝功能不全患者比例未见明显差异(p>0.05)。结论老年患者术前合并冠心病、高血压、糖尿病、慢性肾功能不全,POCD发生率增加,合并慢性肝功能不全两组比例未见明显差异。

Objective To explore the influence of preoperative complications on postoperative cognitive dysfunction （POCD） in elderly patient. Methods 386 patients, aged over 65 years, undergoing gynecological operation involved in the study. Preoparatire examinations were done to record the presence or absence of CHD, HBP, diabetes, chronic renal insufficiency and chronic liver insufficiency. 1 day before and after the operation, Mini -Mental State Examination （MMSE） was used to assess cognitive function, with cognitive dysfunction confirmed when the score by MMSE decreased by 2 points as compared with the preoperative baseline. Then the patients were divided into POCD group and non - POCD group. Results The number of patients suffering from CHD, HBP, diabetes, chronic renal insufficiency in the POCD group was significantly larger than the non -POCD group （p 〈0.05） , but there was no significant difference in patients with chronic liver insufficiency （p 〉 0.05 ） Conclusion The incidence of POCD increases in old patients suffering CHD, HBP, diabetes, chronic renal insufficiency, and have no significant difference in patients with chronic liver insufficiency.