老年患者术后认知功能障碍的研究The study of postoperative cognitive impairment in elderly patients.pdfVIP

提 要 目的：探讨老年骨科手术患者术后认知功能障碍(POCD)的危险因素。分析引起骨 科高龄患者术后认知功能障碍的原因,并找出防治方法及措施。 方法：选择山东中医药大学附属医院骨外科病房择期行骨科手术且年龄60岁的 老年病人50例，使用神经心理学测试量表评估患者术前术后认知功能，分析术后认知 功能障碍发生的影响因素；采用SPSSl1.5统计软件进行数据分析，其中对影响因素分 析采用Logistic逐步回归分析。 结果：年龄、术前合并高血压和术前抑郁与术后认知功能障碍发生有显著性关系， 有统计学意义(P0.05)； 结论：骨科老年患者术后认知功能障碍发病率高，危害大，应该引起骨科同仁的 重视，术前要充分准备，术后要及时纠正各种生理紊乱，进行心理疏导，加强护理。 年龄、术前合并高血压和抑郁是与老年患者术后认知功能障碍发生有关的影响因素， 通过围手术期对骨科手术治疗中的老年患者施行心理干预可以有效减少老年患者术 后认知功能障碍的发生，使老年患者在术后认知功能的各个方面得以改善。 关键词 老年人 骨科 术后认知功能障碍 The Study of Postoperative Cognitive Dysfunction in Elderly Patients Abstract Speciality:Orthopedics of Chinese Medicine Author:Wang jinsong Tutor:Professor.Wang Mingxi Abstract Objective: To investigate factors of the elderly patients being affected by the cognitive dysfunction (POCD) after orthopaedic surgery. To analyze factors that leads to POCD and work out methods to prevent and measure with it. Methods: Choose 50 elderly patients that are over the age of 60 which have done orthopaedic surgery in Shandong traditional Chinese medicine hospital, orthopedics ward, test the cognitive function of the patient before and after the surgery using neuropsychological testing scale, analyze the contributive factors of POCD; doing data analysis with SPSS11.5 statistic software, and take logistic stepwise regression analysis to analyze the contributive factors. Results: Age, preoperative hypertension, and preoperative depression have obvious impact on POCD, which has statistic sense (P0.05). Conclusion: The incidence of POCD attacking the elderly orthopaedic patients is high and the harm is serious, which the orthopaedic colle