在冠状动脉旁路移植术后的患者中,术后认知功能障碍,血清中白素-6和术后狂妄症之间的关联:调解分析
Shan Zhang1, Xiang-Jun Tao2, Shu Ding1,2
1School of Nursing, Capital Medical University, Beijing, China.
Nursing in critical care
|May 3, 2024
概括
手术后妄 (POD) 和升高的IL-6水平是心脏手术后术后认知功能障碍 (POCD) 的关键预测因素. 早期识别这些因素可以有助于制定针对性护理策略来预防POCD.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 关键护理医学 关键护理医学
背景情况:
- 手术后认知功能障碍 (POCD) 是冠状动脉旁路移植 (CABG) 手术后的常见并发症.
- 波多野结衣症显著影响患者的独立性和生活质量.
研究的目的:
- 为了研究术后认知功能障碍 (POCD),术后痴呆症 (POD) 和互白素-6 (IL-6) 水平之间的关联.
- 在接受CABG的患者中确定POCD的预测因素.
主要方法:
- 一项前性队列研究,涉及接受选择性隔离CABG的患者.
- 使用认知功能工具评估POCD,使用CAM-ICU评估妄想.
- 后勤回归和路径分析以确定POD,IL-6和POCD之间的预测值和关系.
主要成果:
- 在212名患者中,25.0%患有POD,32.5%患有POCD.
- POD与POCD的风险增加了四倍 (OR=3.655).
- 手术后6小时升高的IL-6水平 (≥830.50 pg/mL) 将POCD风险增加五倍 (OR=5.042).
结论:
- 手术后妄和手术后6小时的IL-6水平是POCD的显著预测因素.
- 手术后妄并没有介导IL-6和POCD之间的关系.
- 对POD和IL-6水平的早期评估可以为POCD预防提供临床实践的信息.
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