术后低温和术后妄想之间的关系:PNDRFAP研究
Jiahan Wang1, Lei Zhu2, Chuan Li1
1Department of Anesthesiology, Qingdao Municipal Hospital, Qingdao, China.
Brain and behavior
|May 15, 2024
概括
在胃肠道外科手术患者中,手术内低温显著增加了术后狂妄症 (POD) 的风险. 手术后24小时的疼痛评分部分调解了这一关联,突出了潜在的干预点.
科学领域:
- 麻醉学和外科手术期间的医学.
- 神经科学与认知健康
背景情况:
- 手术后妄 (POD) 是手术后的一个常见并发症,特别是在老年患者中.
- 手术期间体温下降,即手术期间体温下降,是不良术后结果的潜在危险因素.
研究的目的:
- 为了研究手术内低温和手术后狂妄症 (POD) 的发生率之间的相关性,在接受胃肠道手术全身麻醉的患者中.
- 探索术后疼痛在手术内低温和POD之间的关系中的潜在调解作用.
主要方法:
- 来自手术期间神经认知障碍风险因子和预后 (PNDRFAP) 研究数据库的510名患者的分析.
- 使用迷你精神状态检查 (MMSE) 评估手术前的认知功能.
- 使用混评估方法和纪念狂妄症评估量表分别评估POD发生率和严重程度.
- 使用后勤回归,调解分析,决策曲线,名谱和ROC曲线分析来评估关联和预测效果.
主要成果:
- 在手术后低温组 (62.2%) 的POD发病率明显高于正常体温组 (9.8%).
- 术内低温独立地与POD风险增加有关 (OR = 4.879,p < .001),即使经过调整以考虑混因素.
- 在手术后24小时的数值评分表 (NRS) 疼痛评分部分介导了手术内低温和POD之间的关系 (14.09%的关联,p = .002).
- ROC曲线表明,手术内低温对POD具有预测价值 (AUC = 0.685).
结论:
- 术内低温是患上胃肠道手术的患者中发生术后痴呆症的重要危险因素.
- 经手术后的疼痛,根据NRS得分进行测量,在低温-POD关联中起着部分调解作用.
- 这些发现表明,维持正常热量和治疗术后疼痛可能对预防POD至关重要.
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