老年骨科全麻患者术后麻醉恢复室谵妄的影响因素分析及防范措施

目的:分析老年骨科全麻患者术后麻醉恢复室谵妄的影响因素,并探讨相关防范措施.方法:选取2018年7月-2020年6月期间我院收治的200例老年骨科全麻患者,收集患者的临床资料.根据其术后麻醉恢复室是否出现谵妄分为观察组(术后发生谵妄)和对照组(术后未发生谵妄),分析术后麻醉恢复室谵妄的影响因素.结果:200例老年骨科全...

Analysis of Influencing Factors and Preventive Measures of Postoperative Delirium in Anesthesia Recovery Room of Elderly Patients with Orthopedic General Anesthesia

Objective:To analyze the influencing factors of postoperative delirium in anesthesia recovery room of elderly orthopedic patients under general anesthesia,and to discuss the relevant preventive measures.Methods:From July 2018 to June 2020,200 elderly patients with general anesthesia in orthopedics department in our hospital were selected,and the clinical data of patients were collected.The patients were divided into observation group(postoperative delirium)and control group(postoperative delirium)according to the postoperative anesthesia recovery room delirium.The influencing factors of postoperative delirium in anesthesia recovery room were analyzed by Multivariate logistic regression analysis.Results:There were 83 cases of postoperative delirium in 200 cases of elderly orthopedic general anesthesia patients,the incidence rate was 41.50%(83/200).Univariate analysis showed that Delirium in the recovery room of elderly orthopedic patients after general anesthesia was associated with age,other basic diseases,smoking history,preoperative blood glucose,preoperative hemoglobin,preoperative hematocrit,type of operation,intraoperative blood loss and electrolyte disorder(P<0.05),while it was associated with gender,body mass index(BMI),Zung There was no correlation between SAS score,preoperative total protein,SDS score,serum potassium and operation time(P>0.05).Multivariate logistic regression analysis showed that age>75 years old,complicated with other basic diseases,preoperative hemoglobin<12 g/dl,intraoperative blood loss≥200 m L,electrolyte disturbance were the risk factors of postoperative delirium in elderly orthopedic patients under general anesthesia(P<0.05).Conclusion:There are many risk factors causing delirium in the anesthesia recovery room of elderly orthopedic patients after general anesthesia,including age,other basic diseases,preoperative hemoglobin,intraoperative blood loss,electrolyte disorder and so on.We should take necessary preventive measures and formulate reasonable operation plan in order to reduce the incidence of postoperative delirium.