大型泌尿外科手术后术后 Delirium 的发生率和术后风险因素
Vesna Jovanovic1,2, Sandra Sipetic Grujicic2,3, Natasa Petrovic1,2
1Center for Anesthesiology and Resuscitation, University Clinical Center of Serbia, Pasterova 2 St., 11000 Belgrade, Serbia.
Diagnostics (Basel, Switzerland)
|December 30, 2025
概括
手术后妄想 (POD) 影响16%的老年男性在泌尿外科手术后. 关键的危险因素包括晚年,COPD和手术后低血压,突出了预防的潜力.
科学领域:
- 老年医学 老年医学
- 手术并发症 手术并发症
- 麻醉学 麻醉学
背景情况:
- 手术后痴呆症 (POD) 是老年手术患者经常出现的并发症.
- 老年人的泌尿外科手术存在POD的重大风险.
- 确定术后风险因素对于POD预防至关重要.
研究的目的:
- 为了确定50岁及以上接受重大泌尿外科手术的男性患者中POD的发病率.
- 在这个队列中调查与POD相关的术后风险因素.
- 确定POD的独立预测因子.
主要方法:
- 对162名男性患者 (≥50岁) 进行了前性观察性研究,这些患者接受了可选的大型泌尿外科手术.
- 使用CAM-ICU每天两次进行5天后术后的 Delirium 评估.
- 多变量回归分析以确定POD的独立风险因素.
主要成果:
- 16%的患者患有POD.
- 确定了独立的危险因素:年龄≥67.5岁,COPD,轻度/中度酒精消费,低的手术前MMSE得分 (≤25.5),手术内低血压和严重的手术后疼痛 (NRS ≥4.85).
- 高龄,并发症 (尤其是COPD),农村生活,酒精消费,手术期间低血压和输血与较高的POD发病率有关.
结论:
- 在接受泌尿外科手术的老年男性中,POD是一个重大问题.
- 确定了几种可修改的POD风险因素,表明预防策略是可行的.
- 优先考虑POD预防对于改善老年手术患者的治疗结果至关重要.
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