在宫癌手术后的老年妇女中,关于妄和长期认知功能之间的关系的回顾性研究
Yefei Wang1, Yongchao Yin2, Zhiqiang Wei1
1Operating Room, Xingtai People's Hospital, Xingtai, Hebei, China.
Medicine
|May 26, 2025
概括
手术后妄想严重影响子宫癌手术后老年妇女的长期认知功能. 早期识别和管理对于缓解持续认知衰退和改善患者结果至关重要.
科学领域:
- 老年医学 老年医学
- 在瘤学瘤学.
- 神经科学是一个神经科学.
背景情况:
- 手术后痴呆症 (POD) 是老年手术患者的常见并发症.
- 在妇科癌症手术后的POD的长期认知后果仍未得到充分研究.
- 接受宫癌手术的老年女性代表了认知障碍的脆弱人群.
研究的目的:
- 为了研究术后妄想和老年妇女宫癌手术后的长期认知功能之间的关联.
- 在这个患者群体中确定长期认知衰退的独立预测因子.
- 提供关于外科手术前认知变化的持续影响的见解.
主要方法:
- 对120名接受宫癌手术的老年妇女 (≥60岁) 的回顾性分析.
- 根据DSM-5标准和混评估方法分类成 Delirium 和 Non-delirium 组.
- 在手术前和手术后1年和3年使用迷你精神状态检查 (MMSE) 评估认知功能.
- 多变量逻辑回归分析以确定认知衰退的独立预测因素.
主要成果:
- 在37.5%的患者中发生了术后妄想.
- 妄症组在手术后1年和3年表现出明显较低的MMSE得分,与非妄症组相比 (P < .05).
- 长期认知衰退的独立预测因素包括术后妄想,年龄较大,健康状况较差,精神病史,手术前使用心理药物和心理困扰.
结论:
- 手术后妄想是宫癌手术后老年妇女长期认知能力下降的重要和持续的危险因素.
- 精神病史和心理困扰被确定为加剧认知恶化的因素.
- 需要加强外科手术期间的认知评估和管理策略,以减轻POD在高风险人群中的长期影响.
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