在全身麻醉后的老年骨科患者中出现 Delirium 的危险因素
Yufan Lu1, Lin Wang1, Ying Wang1
1Department of Anesthesia Surgery, Taizhou Central Hospital (Taizhou University Hospital), Zhejiang, China.
Brain and behavior
|November 11, 2025
概括
出现妄想 (ED) 影响35.1%的老年骨科患者在麻醉后. 关键的危险因素包括尿导管,晚年,术后疼痛和长时间的禁食,这表明需要多式预防策略.
科学领域:
- 麻醉学 麻醉学
- 老年医学 老年医学
- 手术护理 手术护理
背景情况:
- 出现妄想 (ED) 是老年患者麻醉后常见的并发症.
- 在全身麻醉下进行的骨科手术在这个人群中对ED有特定的风险.
研究的目的:
- 为了确定在接受骨科手术的老年患者中ED的发病率.
- 在这个患者群体中确定与ED相关的独立风险因素.
主要方法:
- 一项前性观察性研究的二次分析,涉及接受骨科手术的老年患者 (≥65岁).
- 在多个时间点使用护理 Delirium 查尺度进行ED评估. 麻醉后护理单位 (PACU) 的入院.
- 单变量和多变量逻辑回归分析以确定独立的风险因素.
主要成果:
- 勃起障碍的发病率为35.1% (在242名患者中85名).
- 确定的独立风险因素包括尿导管存在 (OR 4.30),晚年 (OR 1.14),术后疼痛评分 (OR 1.37) 和长时间的固体禁食时间 (OR 1.10).
- 预测模型显示出良好的区分 (AUC 0.77) 和校准.
结论:
- 突发性妄想是老年骨科患者在全身麻醉后经常出现的并发症.
- 尿管导管,长时间的禁食,晚年和术后疼痛是ED的重要危险因素.
- 多模式的临床策略可以有效地减少ED的发生率.
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