不同艾森克评分腹腔镜下子宫切除老年患者术后认知功能障碍发生情况

Cognitive dysfunction among elderly patients after laparoscopic hysterectomy with different eysenck scores

目的研究不同艾森克评分的腹腔镜下子宫切除老年患者术后认知功能障碍的发生情况。方法选取行腹腔镜下子宫切除术老年患者198例为研究对象,对可能影响腹腔镜下老年子宫切除病人发生术后认知功能障碍的危险因素进行统计学分析。结果腹腔镜下子宫切除的198例老年患者中,共有45例患者发生术后认知功能障碍,占22.7%,153例患者未发生术后认知功能障碍,占77.3%;两组患者在年龄≥70岁、文盲、术后12h的疼痛视觉模拟评分、手术时间、术中出血量、罹患高血压、罹患脑梗、罹患糖尿病、术前E维度评分、术前N维度评分和术前P维度评分方面比较差异有统计学意义(P<0.05);多因素Logistic分析的结果表明:年龄≥70岁、术后12h的疼痛视觉模拟评分≥3分、罹患高血压、罹患糖尿病、术前E维度评分≥56.7分和术前N维度评分≥56.7分是导致腹腔镜下子宫切除老年患者术后认知功能障碍发生的危险因素(OR>1,P<0.05)。结论较大的年龄、术后疼痛控制不佳、罹患高血压和糖尿病,性格外向及具有神经质偏向人格的腹腔镜下子宫切除术老年患者更容易发生术后认知功能障碍,应值得我们关注。

Objective To investigate the incidence and risk factors of cognitive dysfunction in elderly patients after laparoscopic hysterectomy with different eysenck scores. Methods 198 cases of elderly patients undergoing laparoscopic hysterectomy were selected. Risk factors that may affect post operative cognitive dysfunction in patients with laparoscopic hysterectomy were analyzed. Results There were 45 patients with postoperative cognitive dysfunction （ POCD ） among 198 elderly patients undergoing laparoscopic hysterectomy, and the proportion was 22. 7% and there were 153 patients who were not affected by POCD, and the proportion was 77.3%. There were significant differences between the two groups of non POCD group and POCD group in age, education, VAS score （postoperative 12h）, operative time, blood loss, hypertension, cerebral infarction, diabetes, preoperative E score, preoperative N score and preoperative P score （P 〈 0. 05）. The results of logistic regression analysis showed ：the age ≥70years, VAS score （ postoperative 12h） ≥3 points, hypertension, diabetes, preoperative E score≥56. 7 points and preoperative N grade score ≥56. 7 point were the risk factors of POCD （ OR 〉 1, P 〈 0. 05）. Conclusion Older age, postoperative pain, poor control of hypertension, diabetes, extrovert and neuroficism and of laparoscopic hysterectomy in elderly patients are more prone to postoperative cognitive dysfunction, which should attract our high attention.