非心脏手术老年患者术中血压变异性与术后谵妄和术后认知功能障碍的相关性研究麻醉学专业论文.docxVIP

高血压发生率无统计学差异(尸O．05)。4．术后炎性因子(TNF-0【和IL-6) 高血压发生率无统计学差异(尸O．05)。4．术后炎性因子(TNF-0【和IL-6) 比较：POD组高于非POD组，差异有统计学意义(尸O．05)；POCD组 和非POCD组差异无统计学意义(尸O．05)。5．Logistic多因素回归：与 POD发生有关的因素为高龄(≥70岁)(P=-0．033，OR：3．248，95％可信 区间：1．098～9．827)，术前认知功能受损(MMSE得分低)(P=-0．036， OR：0．756，95％可信区间：0．581～0．982)，MAP变异高(P=-O．007，OR： 1．009，95％可信区间：1．002～1．015)，TNF．c【(P=-O．024，OR：1．088，95％ 可信区间：1．01l～1．171)和IL．6(产O．012，OR-1．089，95％可信区间： 1．019～1．164)水平高。与POCD发生有关的因素为高龄(t70岁)(卢0．003， OR：6．472，95％可信区间：1．853～22．61 1)，术前认知功能受损(MMSE 得分低)(卢O．013，OR：0．697，95％n-j信区间：0．524-0．927)。结论：1、 发生POD的患者更易发生POCD。2、高龄(／70岁)、术前MMSE分 值，术中患者MAP变异性，术后n盯．仅和IL．6水平与非心脏手术老年患 者POD发生具有相关性。3、高龄(f70岁)、术前MMSE分值与非心 脏手术老年患者POCD发生具有相关性。 关键词：老年；术后谵妄；术后认知功能障碍；血压变异性；炎性因 子；危险因素 万方数据 Correlation Correlation between Blood Pressure Variability and Postoperative Delirium and Postoperative Cognitive Dysfunction in Elderly Patients Undergoing Non··cardiac Surgery Abstract：Objective：Postoperative delirium(POD)and postoperative cognitive dysfunction(POCD)are most common postoperative complications and life．threatening complications in elderly patients．The goal of this study was to observe the correlation between blood pressure variability(BPV)and incidence of POD and POCD in elderly patients undergoing non—cardiac surgery,meanwhile to explore other related risk factors of POD and POCD，and to prevent and treat POD and POCD．Methods：One hundred and fifty patients were selected．Inclusion criteria：@Age≥65；@Anesthesia method was general anesthesia with endotracheal intubation；@ASA I～II；@Non—cardiac surgery；@Operation time was less than three hours． Exclusion criteria：@Patients refused the study；@Illiterates and communication barrier；@)Patients with dementia before surgery；@jPatients could not provide complete observation data；@)Patients with perioperative hypoxemia(SP02 90％)；⑥Bleeding volume was too much(400m1)and the patients received blood transfusion treatment；(DPatients with encephalosis before surgery．One day before the operation，the ment