帕金森病患者围术期不良反应发生情况的回顾性分析

A retrospective analysis of the incidence of perioperative complications in Parkinson’s disease patients accept treatment or not

目的回顾性分析接受与不接受正规药物治疗的帕金森病患者术后不良反应的发生情况,为帕金森病患者的围术期管理提供参考。方法选择2014年1月至2018年5月本院行手术治疗合并帕金森病的患者82例,男45例,女37例,49~89岁,ASAⅡ-Ⅳ级。收集患者资料,根据患者是否就医并遵照医嘱参考中国帕金森病治疗指南(第三版)用药分为治疗组(n=38)和非治疗组(n=44),比较两组患者一般情况,术后镇痛泵的使用率,围术期血管活性药物使用率和不良反应发生率等。结果两组一般情况、术后镇痛泵的使用率差异无统计学意义;治疗组术中血管活性药物使用率和术后疼痛的发生率明显低于非治疗组(P<0.05);术后肺部感染,泌尿系统感染,切口感染,胃肠道反应,认知功能障碍,心律失常,心功能不全,呼吸功能不全等不良反应发生率差异无统计学意义。结论未经正规治疗的帕金森病患者在围术期更容易发生血流动力学的波动,且术后疼痛的发生率更高。

Objective To retrospectively analyze the incidence of postoperative complications in Parkinson’s patients receiving or not receiving regular drug treatment, and provide the basis of perioperative management for Parkinson’s patients. Methods Eighty-two Parkinson’s patients who underwent surgical treatment in our hospital during January 2014 to May 2018 were selected, 45 males and 37 females, aged 49-89 years, ASA Ⅱ-Ⅳ. The basic information of the patients were collected and the patients were divided into the treatment group(n=38) and the non-treatment group(n=44) according to the instructions for the treatment of Parkinson’s disease in China(third edition). The basic information of the patients, the use rate of postoperative analgesia pump and the vasoactive agents, and the incidence of perioperative complications were compared between the two groups. Results There was no significant difference between two groups in the basic information and use rate of postoperative analgesia pump. The use rate of vasoactive agents and incidence of postoperative pain in the treatment group were significantly lower than those in the none-treatment group(P<0.05). There was no significant difference in the incidence of adverse reactions such as pulmonary infection, urinary tract infection, incision infection, gastro-intestinal reactions, postoperative cognitive dysfunction, arrhythmia, cardiac insufficiency and respiratory insufficiency between two groups. Conclusion The incidence of intraoperative(perioperative) hemodynamic instability is higher in Parkinson’s disease patients without regular treatment, and the incidence of postoperative pain is higher.