| 张飒飒.老年TKA术后麻醉恢复室谵妄的危险因素[J].浙江中西医结合杂志,2026,36(2): |
| 老年TKA术后麻醉恢复室谵妄的危险因素 |
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| 投稿时间：2024-10-01 修订日期：2024-11-14 |
| DOI： |
| 中文关键词: 老年,全膝关节置换术,麻醉恢复室,谵妄,危险因素 |
| 英文关键词:Elderly Total knee arthroplasty Post anesthesia unit care Postoperative delirium Risk factors |
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| 中文摘要: |
| [目的] 研究老年全膝关节置换术(TKA)术后麻醉恢复室(PACU)谵妄(POD)发生的危险因素。[方法] 2020年1月—2024年6月本院收治的老年TKA患者210例纳入研究,根据PACU内POD发生与否分为POD组与非POD组,单因素及Logistic多因素回归分析PACU谵妄发生的危险因素,并经由Logistic回归构建预测模型,ROC曲线分析预测价值。[结果] 210例患者中,PACU内POD发生50例(23.8%)。单因素比较:POD组有糖尿病、术前有低蛋白血症、衰弱及营养不良比例、手术时长、术中出血量、术后有低氧血症比例均明显大于非POD组(P＜0.05)。多因素Logistic回归分析:年龄(OR=1.681,P＜0.001)、术中出血量(OR=1.089,P＜0.001)、术后低氧血症(OR=13.209,P=0.019)是PACU内POD发生的独立因素。年龄、术中出血量、术后低氧血症预测PACU内POD发生的AUC分别为0.822、0.889、0.563；基于Logistic回归独立因素的预测方程AUC为0.961。[结论] 年龄大、术中出血量大、术后低氧血症是老年TKA术后PACU内谵妄发生的危险因素,临床需针对性的防治以降低谵妄发生率。 |
| 英文摘要: |
| Objective To study the risk factors of postoperative delirium (POD) in post anesthesia care unit (PACU) after total knee arthroplasty (TKA) in elderly patients. Methods A total of 210 elderly TKA patients admitted to our hospital from January 2020 to June 2024 were included in the study. According to the occurrence of POD in PACU, patients were divided into POD group and non-POD group. The risk factors of delirium in PACU were analyzed by univariate and Logistic multivariate regression. The predictive model was constructed by Logistic regression, and the predictive value was analyzed by ROC curve. Results POD occurred in 50 (23.8%) of 210 patients in PACU. Univariate factor comparison: POD group had significantly higher rates of diabetes, preoperative hypoproteinemia, asthenia and malnutrition, operation duration, intraoperative blood loss and postoperative hypoxemia than non-POD group (P < 0.05). Multivariate Logistic regression analysis showed that age (OR=1.681, P < 0.001), intraoperative blood loss (OR=1.089, P < 0.001) and postoperative hypoxemia (OR=13.209, P=0.019) were independent factors for POD occurrence in PACU. The AUC of age, intraoperative blood loss and postoperative hypoxemia predicting POD occurrence in PACU were 0.822, 0.889 and 0.563, respectively. The prediction equation AUC based on independent factors of Logistic regression was 0.961. Conclusions Old age, large amount of intraoperative blood loss and postoperative hypoxemia are risk factors for delirium in PACU after TKA in the elderly. Targeted prevention and treatment are needed to reduce the incidence of delirium. |
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