高龄结肠癌患者腹腔镜根治术后谵妄发生状况分析

Analysis of the occurrence of delirium in elderly patients with colon cancer after laparoscopic radical resection

目的观察高龄结肠癌患者腹腔镜根治术后谵妄发生状况,并分析术后发生谵妄的影响因素。方法选取2017年1月至2020年1月接受腹腔镜根治术治疗的150例高龄结肠癌患者,依据入选者术后1~3 d内谵妄发生情况分为发生组26例与未发生组124例。调查2组一般资料,比较实验室指标,通过单因素与多因素分析,找出高龄结肠癌患者腹腔镜根治术后谵妄发生的影响因素。结果150例高龄结肠癌患者中,术后发生谵妄26例,发生率为17.33%;发生组与未发生组术前合并基础疾病数量、低氧血症、白蛋白和气腹后动脉血二氧化碳分压(PaCO_(2))水平比较,差异有统计学意义(P<0.05);组间其他基线资料、实验室指标比较,差异无统计学意义(P>0.05)。回归分析结果显示,术前合并基础疾病数量≥3种、低氧血症和气腹后PaCO_(2)过表达均是高龄结肠癌患者腹腔镜根治术后谵妄发生的危险因素(OR>1,P<0.05);白蛋白低表达是高龄结肠癌患者腹腔镜根治术后谵妄发生的保护因素(OR<1,P<0.05)。结论高龄结肠癌患者腹腔镜根治术后谵妄发生风险高,可能受术前合并基础疾病数量≥3种、低氧血症、气腹后PaCO_(2)过表达、白蛋白低表达等因素影响。

Objective To investigate the the occurrence of delirium in elderly patients with colon cancer after laparoscopic radical resection,and to analyze the influencing factors of the occurrence of delirium after operation.Methods A total of 150 elderly patients with colon cancer who underwent laparoscopic radical resection in our hospital from January 2017 to January 2020 were enrolled in the study.According to the occurrence of delirium within 1~3 days after operation,the patients were divided into occurrence group and a non occurrence group.The general data,and laboratory indexes were observed and compared between the two groups.Moreover the univariate analysis and multivariate analysis were used to analyze the influencing factors of delirium in elderly patients with colon cancer after operation.Results Of the 150 elderly patients with colon cancer,26 patients developed delirium after operation,with the incidence rate being 17.33%.There were significant differences in the number of preoperative basic diseases,hypoxemia,albumin and levels of arterial partial pressure of carbon dioxide(PaCO_(2))after pneumoperitoneum between the two groups(P<0.05),but,there were no significant differences in the other baseline data and laboratory indexes between the two groups(P>0.05).Moreover the results of regression analysis showed that the number of preoperative basic diseases was more than 3 kinds,and hypoxemia and PaCO_(2) overexpression after pneumoperitoneum were risk factors for postoperative delirium for patients after laparoscopic radical resection(P<0.05),and low albumin expression was a protective factor for postoperative delirium in the patients(P<0.05).Conclusion The risk of the incidence of postoperative delirium in elderly patients with colon cancer after laparoscopic radical resection is higher,which may be affected by the number of preoperative underlying diseases≥3,hypoxemia,PaCO_(2) overexpression after pneumoperitoneum,and low albumin expression.