微创食管癌术后精神障碍相关危险因素分析

Risk Factors of Mental Disorders after Minimally Invasive Surgery for Esophageal Cancer

目的:探究微创食管癌术后患者发生精神障碍相关危险因素。方法:回顾性分析2015年12月~2020年12月在某院接受微创食管癌手术治疗的617例食管癌患者的临床资料,根据术后是否出现精神障碍将患者分为障碍组(n=43)和对照组(n=574),比较两组患者的临床基线资料和手术指标,应用Logistic回归分析法分析微创食管癌术后出现精神障碍的可能危险因素。结果:障碍组中年龄>70岁、手术时间>360min、ICU入住时长>2d和VAS评分>5分患者比例高于对照组,患者腔隙性脑梗死和低钠血症发生率高于对照组(P<0.05);Logistic多因素分析结果显示,年龄>70岁、腔隙性脑梗死、手术时间>360min、ICU入住时长>2d、低钠血症和VAS评分>5分是食管癌患者术后发生精神障碍的独立危险因素(P<0.05)。结论:食管癌患者术后出现精神障碍由多个因素协同作用导致,高龄、手术时间>360min、ICU入住时长>2d、疼痛刺激、腔隙性脑梗死和低钠血症是食管癌患者术后发生精神障碍的独立危险因素。

Objective:To explore the risk factors of mental disorders after minimally invasive surgery for esophageal cancer.Methods:The clinical data of 617 patients with esophageal cancer treated by minimally invasive surgery in a hospital from December 2015 to December 2020 were retrospectively analyzed.According to the presence or absence of mental disorders after surgery,the patients were divided into disorder group(n=43)and control group(n=574).The clinical baseline data and surgical indicators of the two groups were compared,and logistic regression analysis was performed to screen possible risk factors of mental disorders after minimally invasive surgery for esophageal cancer.Results:The proportions of patients>70 years old,operation time>360 min,ICU stay>2 days and VAS score>5 points in the disorder group were higher than those in the control group.The incidence of lacunar cerebral infarction and hyponatremia was higher than that in the control group(P<0.05).Multivariate logistic analysis showed that age>70 years old,lacunar infarction,operation time>360min,ICU stay>2d,hyponatremia and VAS score>5 points were independent risk factors of mental disorders in patients with esophageal cancer after surgery(P<0.05).Conclusion:Postoperative mental disorders in patients with esophageal cancer are caused by the synergistic effect of multiple factors.Advanced age,operation time>360 min,ICU stay>2 days,painful stimulation,lacunar cerebral infarction,and hyponatremia are independent risk factors for mental disorders in patients with esophageal cancer after surgery.