《中国康复理论与实践》

《中国康复理论与实践》 ›› 2007, Vol. 13 ›› Issue (05): 475-476.

• 临床研究 • 上一篇    下一篇

成年患者胸部手术后认知功能障碍的相关因素及其对临床结局的影响

米俊萍; 秦丽萍   

  1. 中国医科大学第四附属医院麻醉科,辽宁沈阳市 110005
  • 收稿日期:2006-11-24 出版日期:2007-05-01 发布日期:2007-05-01

Postoperative Cognitive Dysfunction in Adult Patients: Risk Factor and Its Influence on Clinical Outcome

MI Jun-ping,QIN Li-ping   

  1. Department of Anesthesiology,The4th Affiliated Hospital of China Medical University, Shenyang 110005, Liaoning,China
  • Received:2006-11-24 Published:2007-05-01 Online:2007-05-01

PDF (PC)

被引次数

12

摘要： 目的观察成年患者胸部手术后认知功能障碍(POCD)的相关因素及其对治疗结局的影响。方法选择近期在我院行胸部手术治疗患者122例,全部入选对象在手术前3d内和术后第7天时分别接受韦氏成人智测量表(WAIS-RC)调查,出院前测定其肺功能,并统计其卧床时间、住院总时间、住院总花费、术后住院时间、重症监护室停留时间。结果术后第7天确诊为POCD45例(POCD组),患病率31.25%。术前一般资料比较中,POCD患者平均年龄、平均体重指数、平均吸烟指数和合并动脉硬化危险因素数目均大于无POCD组(77例)(均P<0.05)。WAIS-RC分量表智测成绩比较,POCD组术前的知识、领悟、算术、数字广度、词汇、图形排列和图形拼凑等分量表评分均低于认知功能正常组(均P<0.05)。术后临床经过中,POCD组患者各项肺功能指标均明显差于无POCD组,卧床时间、住院总时间、住院总花费、术后住院时间、重症监护室停留时间均高于无POCD组(均P<0.05)。结论胸部手术后POCD患者住院时间长、肺功能指标差、治疗成本高。

关键词: 胸部外科, 认知功能, 胸部手术后认知功能障碍(POCD), 肺功能, 韦氏成人智测量表

Abstract: Objective To investigate the influence of postoperative cognitive dysfunction (POCD) to clinical outcome in adult patients and the risk factor. Methods 122 patients after operation on chest were surveyed with Wechsler Adult Intelligence Scale-Revised China (WAIS-RC) within 3 d before operation and on the 7th day after operation. Their pulmonary functions were measured before discharged. Their time on bed, total time in hospital, time after operation in hospital, time in intensive care unit and spending for therapy were investigated. Results 45 patients were finally diagnosed as POCD (POCD group) 7 d after operation. Before operation, the age, the body weight index, the smoking index and the number of risk factor of angiosclerosis in the POCD group were all higher than those whose cognitive function were normal (normal group) (P<0.05). The sores of insight, count, digit scope, vocabulary, figure collocation, figure patch of WAIS-RC in POCD group were obviously lower than those in normal group (P<0.05). Every index of pulmonary function in POCD group was lower than those in normal group(P<0.05). The time keeping on bed, total time in hospital, time after operation in hospital, time in intensive care unit and spending for therapy in POCD group all exceeded those in normal group (P<0.05).Conclusion The adult patients with POCD may spend more time and money for therapy in hospital, and their pulmonary functions may be recovered poorly.

Key words: thoracic surgery, cognitive function, postoperative cognitive dysfunction (POCD), pulmonary function, Wechsler Adult Intelligence Scale