老年患者口腔肿瘤皮瓣修复术后谵妄的相关危险因素分析

Analysis of related risk factors for delirium after oral tumor flap repair in the elderly

目的通过回顾性分析,探讨老年患者口腔肿瘤皮瓣修复术后谵妄的相关危险因素。方法通过检索电子病例系统,搜集2019年8月至2020年10月行口腔肿瘤皮瓣修复手术的老年患者360例,采集患者相关资料并评估术后谵妄的发生情况,排除未完成电话随访的病例后,最终有350例患者纳入本次研究,包括术后谵妄患者105例(D组),未发生术后谵妄患者245例(ND组)。采用SPSS 20.0软件进行统计分析。结果本研究中,D组的高血压发生率为85%,ND为57%,两组差异显著(P<0.05);失血量、手术时间、年龄、气管切开、术中用药及补液、术后预防性用药等方面,两组均无显著差异(P>0.05);Logistic回归分析进一步提示,术前高血压史可作为老年口腔肿瘤皮瓣修复术后谵妄的独立危险因素。结论对于行口腔肿瘤皮瓣修复术的老年患者而言,高血压史可作为术后发生谵妄的高危因素。

Objective To explore the risk factors of delirium after oral tumor flap repair in the elderly through retrospective case analysis.Methods Through searching the electronic case system,a total of 360 elderly patients undergoing oral tumor flap repair from August 2019 to October 2020 were collected,and the relevant research data of the patients were collected and the postoperative delirium was assessed.The patients who did not complete telephone follow-up were excluded.A total of 350 patients completed this study,including 105 patients with postoperative delirium(set as group D)and 245 patients without postoperative delirium(set as group ND).SPSS 20.0 software package was used for statistical analysis of the result data.Results For elderly patients undergoing flap repair,the incidence of hypertension in group D(85%)was significantly higher than that in group ND(57%,P<0.05),but there were no significant differences in blood loss,operative time,age,tracheotomy,intraoperative medication and fluid replacement,postoperative prophylactic medication between the two groups(P>0.05).Logistic regression analysis further suggested that preoperative history of hypertension could be an independent risk factor for postoperative delirium after oral tumor flap repair in the elderly.Conclusion For elderly patients undergoing oral tumor flap repair surgery,history of hypertension can be a high risk factor for postoperative delirium.