腹部恶性肿瘤患者围手术期谵妄危险因素分析

Analysis of Risk Factors for Perioperative Delirium in Patients with Abdominal Malignant Tumor

目的总结腹部恶性肿瘤患者围手术期谵妄的危险因素。方法选取2016年5月～2018年5月本院住院部收治的120例腹部恶性肿瘤患者作为观察组,选择同期入院腹部恶性肿瘤患者,围手术期未出现谵妄症状的40例患者作为对照组,以自制调查问卷详细记录患者围手术期相关因素。结果观察组高血压发生率(66.67% VS 40.00%,P <0.05)、糖尿病发生率(60.00% VS 30.00%,P <0.05)、冠心病发生率(54.17% VS 22.50%,P <0.05)、手术时间3小时以上比例(58.33% VS 30.00%,P <0.05)、术后低氧血症发生率(60.00% VS 32.50%,P <0.05)、电解质紊乱发生率显著高于对照组(56.67% VS 45.00%,P <0.05)。高血压、糖尿病、手术时间3小时以上、术后低氧血症、电解质紊乱、术后VRS评分≥4分为围手术期谵妄发生的危险因素。手术时间3小时以上(OR=6.174,P <0.05)、术后低氧血症(OR=6.857,P <0.05)、电解质紊乱(OR=5.836,P <0.05)、术后VRS评分≥4分(OR=6.027,P<0.05)。结论腹部恶性肿瘤患者围手术期谵妄与手术时间过长、术后低氧血症、电解质紊乱、术后疼痛等密切相关。

Objective To summarize the risk factors of perioperative delirium in patients with abdominal malignant tumors. Methods A total of 120 patients with abdominal malignant tumors admitted to the inpatient department of our hospital between May 2016 and May 2018 were enrolled as the observation group. 40 patients with abdominal malignant tumors who were admitted to the hospital at the same time were selected as the control group. The related perioperative factors were recorded in detail using a self-made questionnaire. Results The incidence of hypertension in the observation group（66.67% vs 40.00%, P〈0.05）, the incidence of diabetes（60.00% VS 30.00%, P〈0.05）, the incidence of coronary heart disease（54.17% vs 22.50%, P〈0.05）, The operation time of more than 3 hours（58.33% vs 30.00%, P〈0.05）, the incidence of postoperative hypoxemia（60.00% vs 32.50%, P〈0.05）, and the incidence of electrolyte disturbance was significantly higher than that of the control group（56.67% VS 45.00%, P〈0.05）. Hypertension, diabetes, operative time of more than 3 hours, postoperative hypoxemia, electrolyte imbalance, postoperative VRS score ≥ 4 were classified as risk factors for perioperation. The operation time of more than 3 hours（OR=6.174, P〈0.05）, postoperative hypoxemia（OR=6.857, P〈0.05）, electrolyte disturbance（OR=5.836, P〈0.05）, postoperative VRS score ≥4（OR = 6.027, P〈0.05）. Conclusion Perioperative sputum in patients with abdominal malignant tumors is closely related to long operation time, postoperative hypoxemia, electrolyte imbalance and postoperative pain.