腹腔镜胆囊切除术患者术后发生认知功能障碍的影响因素

Influencing factors of postoperative cognitive dysfunction in patients undergoing laparoscopic cholecystectomy

目的:分析腹腔镜胆囊切除术(LC)患者术后发生认知功能障碍的影响因素。方法:回顾性分析2022年6月至2023年6月该院收治的80例行LC的胆囊结石患者的临床资料,术后随访15 d,根据术后是否发生认知功能障碍将其分为发生组和未发生组。比较两组基线资料,采用Logistic回归分析LC患者术后发生认知功能障碍的影响因素。结果:80例行LC的胆囊结石患者,术后19例发生认知功能障碍,发生率为23.75%(19/80);两组性别、体质量指数、合并高血压、合并高脂血症、吸烟史、饮酒史比较,差异均无统计学意义(P>0.05);两组年龄、手术时间、气腹压、术后镇痛、合并糖尿病情况比较,差异均有统计学意义(P<0.05);Logistic回归分析结果显示,年龄≥60岁、手术时间≥60 min、气腹压≥11.2 mmHg、合并糖尿病均为LC患者术后发生认知功能障碍的危险因素(OR>1,P<0.05),有术后镇痛为LC患者术后发生认知功能障碍的保护因素(OR<1,P<0.05)。结论:年龄≥60岁、手术时间≥60 min、气腹压≥11.2 mmHg、合并糖尿病均为LC患者术后发生认知功能障碍的危险因素,有术后镇痛为LC患者术后发生认知功能障碍的保护因素。

Objective:To analyze influencing factors of postoperative cognitive dysfunction in patients undergoing laparoscopic cholecystectomy(LC).Methods:The clinical data of 80 patients with cholecystolithiasis who underwent LC in this hospital from June 2022 to June 2023 were retrospectively analyzed.These patients were followed up for 15 days after the surgery.According to whether postoperative cognitive dysfunction occurred,they were divided into the occurrence group and the non-occurrence group.The baseline data of the two groups were compared.Logistic regression was used to analyze the influencing factors of postoperative cognitive dysfunction in the LC patients.Results:Among the 80 patients with cholecystolithiasis who underwent LC,19 developed cognitive dysfunction after the surgery with an incidence rate of 23.75%(19/80).There were no statistically significant differences in gender,body mass index,combined hypertension,cholecystolithiasis hyperlipidemia,smoking history,and alcohol consumption history between the two groups(P>0.05).There were significant differences in age,operation time,pneumoperitoneum pressure,postoperative analgesia and diabetes between the two groups(P<0.05).Logistic regression analysis showed that age≥60 years,operation time≥60 minutes,pneumoperitoneum pressure≥11.2 mmHg,and combined diabetes were risk factors for postoperative cognitive dysfunction in the LC patients(OR>1,P<0.05),and postoperative analgesia was a protective factor for postoperative cognitive dysfunction in the LC patients(OR<1,P<0.05).Conclusions:Age≥60 years old,operation time≥60 min,pneumoperitoneum pressure≥11.2 mmHg and combined diabetes are the risk factors for postoperative cognitive dysfunction in the LC patients,and postoperative analgesia is the protective factor.