老年颈动脉狭窄患者颈内动脉支架置入术后认知功能障碍的影响因素分析

Influencing factors of the elderly carotid artery stenosis patients’cognitive dysfunction after the stent placement in internal carotid artery surgery

目的调查分析老年颈动脉狭窄患者颈内动脉支架置入术(CAS)后认知功能障碍(POCD)的影响因素,提出相应防护措施。方法选取2019年10月—2020年8月在医院接受CAS治疗的老年颈动脉狭窄患者患者300例为研究对象,按照CAS后是否并发POCD分为POCD组45例和非POCD组255例,通过单因素和多因素Logistic回归分析探讨术后POCD相关危险因素。结果入选患者300例,共有45例发生POCD,发生率为15%。经单因素与多因素Logistic回归分析显示:年龄>60岁、重度颈动脉狭窄、有动脉粥样硬化史、焦虑抑郁是术后POCD独立相关因素(P<0.05)。结论老年颈动脉狭窄患者CAS后POCD的影响因素多而复杂,年龄、颈动脉狭窄程度、动脉粥样硬化史、焦虑抑郁均会加大术后POCD发生风险,因此临床护理人员应积极开展风险评估培训,合理调控身心健康指标控制,以降低术后POCD风险,改善预后。

Objective To investigate influencing factors of the elderly carotid artery stenosis patients’cognitive dysfunction(POCD)after the carotid artery stenting(CAS)surgery and to propose corresponding protective measures.Methods To select 300 elderly cerebral infarction patients with carotid artery stenosis who underwent the CAS surgery in the hospital from October 2019 to August 2020 as the research objects.According to the occurance of POCD after CAS,45 cases were divided into POCD group and 255 cases were divided into nonPOCD group.Unifactor analysis and multivariate Logistic regression analysis was taken to explore the risk factors of POCD after surgery.Results Among 300 patients,45 cases occurred POCD,the incidence rate was 15%.Univariate screening and multivariate Logistic regression analysis showed that:age>60 years old,severe carotid artery stenosis,history of atherosclerosis,anxiety and depression were independent factors correlated with POCD(P<0.05).Conclusion There were various and complex influencing factors of POCD in elderly patients with carotid stenosis after CAS,age,degree of carotid artery stenosis,history of atherosclerosis,anxiety and depression could increase the risk of POCD after CAS.The clinical nurse should carry out the risk assessment training positively and reasonably control the physical and mental health indicators to reduce the risk of POCD and improve the prognosis.