地塞米松对高原患者膝关节置换术后谵妄的影响

Effect of dexamethasone on delirium after knee replacement in high altitude patients

目的目的探讨地塞米松对高原患者膝关节置换术后谵妄(POD)的影响。方法方法选择2018年1月~2022年12月择期在本院行全麻下膝关节置换术的患者842例。根据是否在手术切皮前静脉使用地塞米松,分为地米组(460例)术前行静脉注射地塞米松,对照组(382例),术前未用地塞米松。对比两组术后7d内谵妄的发生率。结果结果发生POD:地米组44例(9.6%),对照组56例(14.7%),存在统计学差异(P=0.014);多因素logistic回归模型校正混杂因素后:静脉使用地塞米松可减少高原患者膝关节置换术POD的发生风险(P=0.030)。结论结论术前静脉使用地塞米松可减少择期全麻下膝关节置换术患者POD的发生风险。

Objective To investigate the effect of dexamethasone on postoperative delirium(POD)in patients with high altitude after knee replacement.Methods From January 2018 to December 2022,842 patients underwent knee replacement under general anesthesia in our hospital.According to whether dexamethasone was used intravenously before operation,the patients in the dexa-methasone group(460 cases)received intravenous dexamethasone before operation,and the control group(382 cases)did not re-ceive dexamethasone before operation.The incidence of delirium within 7 days after operation was compared between the two groups.Results POD occurred in 44 cases(9.6%)in dexamethasone group and 56 cases(14.7%)in control group,with statistical difference(P=0.014).Multivaiate logistic regression model adjusted for confounders:intravenous dexamethasone reduced the risk of POD in knee replacement patients with high altitude(P=0.030).Conclusion Preoperative intravenous dexamethasone cloud re-duce the risk of POD in patients undergoing knee arthroplasty under elective general anesthesia.