Stanford A型主动脉夹层患者发生术后谵妄的危险因素研究

Risk factors of postoperative delirium in patients with Stanford type A aortic dissection

目的探究Stanford A型主动脉夹层术后谵妄发生的相关危险因素,分析术后感染与术后谵妄之间的关系。方法选择2016年2月至2018年8月温州医科大学附属第一医院心脏中心手术治疗的Stanford A型主动脉夹层患者108例,其中43例(39.8%)发生术后谵妄。收集发生与未发生谵妄患者的术中、术后观测指标及临床转归并进行对照研究。采用单因素分析及多因素二元logistic回归分析,探究Stanford A型主动脉夹层术后谵妄发生的独立危险因素。结果谵妄组患者气管插管时间、ICU住院时间、住院总时间均长于对照组,差异均有统计学意义(P<0.05)。单因素分析及多因素二元logistic回归分析提示:术后感染为Stanford A型主动脉夹层患者发生术后谵妄的独立危险因素。结论Stanford A型主动脉夹层患者术后谵妄发生率较高,可影响其术后恢复。术后感染为其发生的独立危险因素。

Objective To investigate the risk factors of postoperative delirium in patients with Stanford type A aortic dissection.Methods The clinical data of 108 patients with Stanford type A aortic dissection who underwent surgical treatment in Cardiac Center of the First Affiliated Hospital,Wenzhou Medical University from February 2016 to August 2018 were retrospectively analyzed.The postoperative delirium occurred in 43 cases with an incidence rate of 39.8%.Univariate and multivariate logistic regression analysis were used to explore the independent risk factors of postoperative delirium.Results The total tracheal intubation time,length of ICU stay and total hospital stay in delirium group were longer than those in non-delirium group(P<0.05).Univariate and multivariate logistic regression analysis indicated that postoperative infection was an independent risk factor for postoperative delirium in patients with Stanford type A aortic dissection.Conclusion The incidence of postoperative delirium in Stanford type A aortic dissection is high,and postoperative infection is an independent risk factor of postoperative delirium.