老年患者心脏手术后认知功能障碍影响因素的临床研究

Clinical research factors in elderly patients after cardiac surgery affect cognitive dysfunction

目的:探讨影响老年患者心脏手术后认知功能的因素,分析可能的预防方法。方法:对300例行心脏手术的患者,术前术后各进行简易智力精神状态检查量表评分,用单因素比较和多因素Logistic回归方法,分析各因素对患者发生术后认知功能障碍(POCD)的影响。结果:Logistic回归分析结果显示年龄、受教育程度、体外循环时间、ICU停留时间与患者术后POCD的发生有关(P<0.05)。结论:临床工作中应重视患者术前指导,减少手术因素的影响,加强患者术后依从性。一旦出现术后POCD,应积极消除致病因素,控制精神症状。

Objective： To investigate factors in elderly cardiac surgery patients with cognitive function,analysis of possible methods of prevention. Methods： 300 patients undergoing cardiac surgery,preoperative and postoperative each perform simple mental Mental State Examination score,comparing with univariate and multivariate logistic regression analyzes in patients with dysfunction of various factors on postoperative cognitive affected. Results： Logistic regression analysis showed that age,education level,CPB time,ICU stay time and postoperative cognitive dysfunction related to the occurrence（ P〈0 05）. Conclusion： The clinical work should pay attention to patients with preoperative guidance,reduce the impact of surgical factors,strengthen postoperative compliance. Once postoperative cognitive dysfunction,should actively eliminate pathogenic factors,control psychotic symptoms.