摘要
目的 探讨术前血清白细胞介素17(IL-17A)、血清尿酸(SUA)及修正衰弱指数与妇科肿瘤患者腹腔镜术后谵妄的关系.方法 选取2021年5月至2023年5月石家庄市妇幼保健院择期全麻下行腹腔镜妇科肿瘤切除术患者148例为研究对象,根据患者术后谵妄情况分为术后谵妄组(POD,45例),及非术后谵妄组(NPOD,103例),比较两组术前血清IL-17A、SUA及修正衰弱指数,分析其对POD的预测效能.结果 POD组年龄、苏醒时间、IL-17A、SUA、修正衰弱指数水平较NPOD组高,清蛋白水平较NPOD低,差异有统计学意义(t=9.411、19.818、6.264、6.218、28.617、9.470,P<0.05);Logistic多因素回归分析,年龄、苏醒时间、IL-17A、SUA、修正衰弱指数为术后谵妄的危险因素,清蛋白为术后谵妄的保护因素(P<0.05);ROC曲线结果显示,IL-17A、SUA、修正衰弱指数三者单独及联合检测预测妇科肿瘤患者腹腔镜POD的曲线下面积(AUC)分别为0.845、0.835、0.876、0.933,三者联合预测优于单一预测(P<0.05).结论 POD患者IL-17A、SUA、修正衰弱指数水平均升高,且IL-17A、SUA、修正衰弱指数均为POD的相关危险因素,三者联合检测对妇科肿瘤患者腹腔镜POD具有较高的预测价值.
Abstract
Objective To investigate the relationship between preoperative serum levels of IL-17A,SUA and modified frailties index and postoperative delirium in patients with gynecological tumors after laparoscopy. Methods A total of 148 patients who underwent laparoscopic gynecological tumor resection under elective general anesthesia at the Sixth People ' s Hospital of Shijiazhuang from May 2021 to May 2023 were selected for this study. The patients were divided into two groups based on postoperative delirium:the postoperative delirium group(POD,45 cases),and the non-postoperative delirium group(NPOD,103 cases). The preoperative serum levels of IL-17A,SUA and the modified frailty index were compared between the two groups to analyze their predictive efficacy for POD. Results The levels of age,recovery time,IL-17A, SUA and modified frailty index in the POD group were higher than those in the NPOD group. The difference was statistically significant (t=9.411,19.818,6.264,6.218,28.617,9.470,P<0.05). Logistic regression analysis showed that age,recovery time,IL-17A,SUA and modified frailty index were risk factors for postoperative delirium,and albumin was a protective factor for postoperative delirium(P<0.05). The ROC curve results showed that the area under the curve(AUC)of laparoscopic POD in patients with gynecological tumors predicted by IL-17A,SUA,and modified frailty index alone and in combination were 0.845,0.835,0.876, and 0.933. The combined prediction is better than the single prediction. Conclusion The levels of IL-17A,SUA,and the modified frailty index were all increased in POD patients. IL-17A,SUA,and the modified frailty index were identified as risk factors for POD. The combined detection of these three factors showed a high predictive value for laparoscopic POD in patients with gynecological cancer.
维普
万方数据