标题：老年患者术后认知功能障碍发生情况及相关因素研究

      作者：李海泉 1，陈佳儒 1，黄泽艺 2    （郁南县人民医院麻醉科 1、外科 2，广东 郁南 527199）

      卷次： 2016年27卷23期

      【摘要】 目的 探讨老年患者术后认知功能障碍（POCD)发生情况及相关影响因素。方法 选择2015年1月至2016年6月期间我院收治的400例老年择期手术患者，采用简易智力量表(MMSE)评分，术后下降≥4分判断为发生POCD，调查术后POCD的发生率，根据是否发生POCD将患者分为POCD组、非POCD组，比较两组患者临床资料。结果 本组400例患者中术后发生POCD 63例，发生率为15.75%；POCD组患者受教育年限为(3.2±1.2)年，短于非POCD组的(4.1±1.7)年，高血压、全麻比例，麻醉时间>200 min者比例分别为46.03% (29/63)、60.32% (38/63)、50.79%(32/63)，均高于非POCD组的32.64% (110/337)、42.73% (144/337)、32.64% (110/337)，差异均有统计学意义(P<0.05)。结论 POCD是老年手术患者常见并发症，其发生与受教育年限短、术前合并高血压以及全麻、麻醉时间长等因素有关。
      【关键词】 老年；麻醉；术后认知功能障碍；影响因素
      【中图分类号】 R619 【文献标识码】 A 【文章编号】 1003—6350（2016）23—3906—02

Incidence and related factors of postoperative cognitive dysfunction in elderly patients.
LI Hai-quan 1, CHENJia-ru 1, HUANG Ze-yi 2. Department of Anesthesia 1, Department of Surgery 2, Yunan People's Hospital, Yunan 527199,Guangdong, CHINA
【Abstract】 Objective To investigate the incidence and related factors of postoperative cognitive dysfunction(POCD) in elderly patients. Methods A total of 400 cases of elderly patients scheduled for surgery in our hospital fromJanuary 2015 to June 2016 were selected. The cognitive dysfunction of these patients was evaluated using Mini-MentalState Examination (MMSE). The patients were diagnosed as having POCD if postoperative MMSE scores decreasedby≥4 compared with that before operation. The incidence of POCD was investigated. The patients were divided intotwo groups for POCD group and non-POCD group according to whether with POCD. The clinical data between the twogroups were compared. Results In this study, 63 patients had postoperative POCD, and the incidence was 15.75%. Theeducation attainment of patients in POCD group were (3.2 ± 1.2) years, which were significantly shorter than that ofnon-POCD group of (4.1±1.7) years. The ratio of hypertension, general anesthesia, anesthesia time>200 min in POCDgroup were respectively 46.03% (29/63), 60.32% (38/63), 50.79% (32/63), which were significantly higher than those innon-POCD group of 32.64% (110/337), 42.73% (144/337), 32.64% (110/337), and the differences were statistically sig-nificant (P<0.05). Conclusion POCD is a common complication in elderly patients after surgery. It is related to the in-fluencing factors as short duration of education, high blood pressure before operation, general anesthesia and long dura-tion of anesthesia.
      【Key words】 Elderly; Anesthesia; Postoperative cognitive dysfunction (POCD); Influencing factors·临床经验·doi:10.3969/j.issn.1003-6350.2016.23.039基金项目：广东省云浮市2015年度科技计划项目(编号：2015B87)