目的分析老年患者腹部手術(shù)后認(rèn)知功能障礙(POCD)發(fā)生的高危因素。方法回顧性分析我院2000年2月至2010年10月期間60歲以上2 286例腹部手術(shù)后患者的臨床資料，根據(jù)是否發(fā)生POCD將2 286例患者分為POCD組和非POCD組，其中POCD組38例，非POCD組2 248例。分析影響腹部手術(shù)后POCD發(fā)生的影響因素，包括年齡、性別、麻醉方式、術(shù)前是否用藥〔地西泮和(或)阿托品或東莨菪堿〕、術(shù)前是否存在心肺疾病、術(shù)前是否有糖尿病、術(shù)前有無(wú)黃疸、術(shù)前有無(wú)貧血或低蛋白血癥、手術(shù)持續(xù)時(shí)間及術(shù)后是否進(jìn)行持續(xù)鎮(zhèn)痛治療。結(jié)果POCD的發(fā)生與患者年齡、麻醉方式、術(shù)前是否存在心肺疾病、術(shù)前是否有糖尿病、術(shù)前有無(wú)黃疸、手術(shù)持續(xù)時(shí)間是否超過(guò)4 h、術(shù)后是否進(jìn)行持續(xù)鎮(zhèn)痛有關(guān)(Plt;0.05)，而與患者性別、術(shù)前是否用藥和術(shù)前有無(wú)貧血或低蛋白血癥無(wú)關(guān)(Pgt;0.05)。結(jié)論年齡≥70歲、全身麻醉、術(shù)前存在心肺疾病、糖尿病和黃疸、手術(shù)持續(xù)時(shí)間超過(guò)4 h、術(shù)后未進(jìn)行持續(xù)有效的鎮(zhèn)痛是腹部手術(shù)后POCD發(fā)生的高危因素。
【摘要】 目的 探討腹部非胃、十二指腸手術(shù)后胃癱綜合征（postoperative gastroparesis syndrome，PGS）發(fā)生的高危因素?！》椒ā』仡櫡治?004年9月-2010年3月2 559例腹部非胃、十二指腸術(shù)后患者的臨床資料，將患者分為PGS組和非PGS組，其中PGS組23例，非PGS組2 536例?！〗Y(jié)果 比較PGS組和非PGS組間年齡、性別、術(shù)后開始進(jìn)食時(shí)間、手術(shù)持續(xù)時(shí)間、是否為腫瘤晚期、有無(wú)貧血低蛋白血癥、既往有無(wú)腹部手術(shù)史、術(shù)后早期有無(wú)營(yíng)養(yǎng)支持等因素，χ2值分別為:19.687、0.018、0.346、48.243、21.801、16.803、24.679、0.870，P值分別是:lt;0.01、gt;0.05、gt;0.05、lt;0.01、lt;0.01、lt;0.01、lt;0.01、gt;0.05。 結(jié)論 年齡gt;65歲、手術(shù)持續(xù)時(shí)間gt;4 h、腫瘤晚期、既往有腹部手術(shù)史及貧血低蛋白血癥是腹部非胃、十二指腸手術(shù)后PGS發(fā)生的高危因素?！続bstract】 Objective To analyze the risk factors of postoperative gastroparesis syndrome (PGS) after non-gastroduodenal abdominal surgery. Methods We retrospectively analyzed the clinical data of 2 559 patients who underwent non-gastroduodenal abdominal surgeries in our hospital between September 2004 and March 2010. We divided them into the PGS group with 23 patients and the non-PGS group with 2 536 patients. Results By comparing the age, the gender, the starting time of eating after surgery, the duration of surgery, whether the patients had advanced cancer, whether anemia or hypoproteinemia existed, whether the patients had a history of previous abdominal surgery, and whether nutritional support was provided early after operation between the PGS group and the non-PGS group, we found that the chi-square value was 19.687, 0.018, 0.346, 48.243, 21.801, 16.803, 24.679, 0.870 and the P value waslt;0.01, gt;0.05, gt;0.05, lt;0.01, lt;0.01, lt;0.01, lt;0.01, gt;0.05 respectively. Conclusion Over 65 years of age, the duration of surgery over four hours, advanced cancer, the history of previous abdominal surgery and anemia or hypoproteinemia are the risk factors of PGS after non-gastroduodenal abdominal surgery.