老年患者术后谵妄的危险因素及预防措施

Risk factors and preventions of postoperative delirium in the elderly

术后谵妄(POD)是老年患者常见的并发症。目前已知与POD发生的相关因素有年龄、痴呆、术前脑功能损害、认知感觉功能缺陷和(或)运动功能缺陷、术前合并疾病、多种药物用药史等;以上危险因素加之麻醉、手术、失血,低血压和疼痛及其他相关因素可导致POD,严重影响患者术后生活质量,增加术后死亡率和术后并发症(如跌倒、感染)、延长住院时间、增加术后重症监护病房(ICU)停留时间,加重社会经济负担和占据医疗资源。因此,早期识别POD危险因素、预防老年患者POD的发生显得尤为迫切。

Postoperative delirium(POD)is a common complication in geriatric patients,the predisposing factors associated with POD include aging,dementia,preoperative brain injury,deficits in cognitive,sensory or mobility dysfunctions,multiple comorbidities or receiving poly-medications prior to surgery.It also believes that other factors like anesthetic agents,the surgical procedures,blood loss,hypotension and pain can significantly contribute to POD.The POD is associated with increased postoperative morbidity and mortality,cognitive impairment,and complications(such as falls,infections),with prolonged intensive care and hospital stays,and increased the utilization of hospital s resources and healthcare costs.Therefore,it is critical to identify risk factors related to POD and prevent the incidence of POD.