老年病人结直肠癌根治术后早期认知功能障碍的危险因素分析

Risk factors for early postoperative cognitive dysfunction after radical resection of colorectal cancer in elderly patients

目的分析老年病人结直肠癌根治术后发生早期认知功能障碍的危险因素。方法 80例接受全身麻醉下结直肠手术的老年病人纳入研究,术前1 d和术后第7天进行认知功能评定,根据"Z"计分法判定是否发生术后认知功能障碍(POCD),采用Logistic多元逐步回归分析POCD危险因素。结果 19例病人被判定为POCD (24.7%)。Logistic多元逐步回归分析显示,糖尿病史(OR=8.391,95%CI:2.208~31.882),术后禁食时间≥3 d(OR=5.236,95%CI:1.998~13.721),术后第2天全身炎症反应(SIRS)评分≥3分(OR=6.995,95%CI:1.948~25.111)是老年结直肠根治术后早期POCD的危险因素。结论糖尿病史、术后禁食时间≥3 d以及术后第2天SIRS评分≥3分对老年病人结直肠术后发生早期POCD产生影响。

Objective To investigate the risk factors of early postoperative cognitive dysfunction（POCD） in the elderly patients receiving radical resection for colorectal cancer.Methods Eighty elderly patients who received radical resection for colorectal cancer under general anesthesia were enrolled.Neuropsychological tests were performed preoperatively and at the seventh day after operation.The risk factors for POCD were analyzed using a multivariate Logistic regression model.Results Nineteen patients were diagnosed as POCD（24.7%）.Diabetes history（OR=8.391,95% CI：2.208-31.882）,fasting over three days after surgery（OR=5.236,95%CI：1.998-13.721） and SIRS score〉3 on the second day after surgery（OR=6.995,95%CI：1.948-25.111） were risk factors of early POCD in the elderly patients after radical resection for colorectal cancer.Conclusions The risk factors for early POCD after radical resection of colorectal cancer in the elderly patients include diabetes history,fasting over three days,and SIRS score〉3 on the second day.