首页|老年患者术后谵妄与围术期炎症因子变化及相关因素的关系

老年患者术后谵妄与围术期炎症因子变化及相关因素的关系

扫码查看
目的:探讨老年患者术后谵妄与围术期炎症因子变化及相关因素的关系.方法:收集本院2023年8月—2024年5月间行择期手术的老年患者260例.采用随机数字法分为全麻组(G组)和区域阻滞(L组),各130例.比较两组患者术后谵妄发生情况及血清白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)、中枢神经特异蛋白(S100-β)变化,应用Logistic风险回归模型分析影响术后谵妄的单(P<0.05)因素及多因素.结果:G组患者术后谵妄共31例,发生率为23.85%,高于L组(17例,13.08%),差异有统计学意义(P<0.05);两组术后3d血清IL-6、TNF-α及S100-β水平均高于术前,但两组术后3d 血清IL-6、TNF-α及S100-β水平组间比较,差异无统计学意义;术后谵妄患者术前MMSE评分低于无谵妄患者,ASA分级、手术时间、术后VAS评分、IL-6、TNF-α及S100-β水平和高龄占比均高于或长于术后无谵妄患者;Logistic单因素分析结果:ASA分级、术前MMSE评分、手术时间、术后IL-6、TNF-α、S100-β、麻醉方式、高龄与术后谵妄有关;Logistic多因素分析结果:麻醉方式(全麻)、术前MMSE评分、术后IL-6、TNF-α及S100-β、高龄为术后谵妄的危险因素.结论:老年患者术后谵妄与麻醉方式、术前MMSE评分、术后血清IL-6、TNF-α及S100-β、高龄等有关,通过监测上述因素,可为术后谵妄的防治提供参考.
The relationship between postoperative delirium in elderly patients and changes in perioperative inflammatory factors and related factors
Objective To investigate the relationship between postoperative delirium and perioperative inflammatory factors in elderly patients.Methods 260 elderly patients undergoing elective surgery in our hospital from August 2023 to May 2024 were collected.They were randomly divided into general anesthesia group(group G)and regional anesthesia group(group L),130 cases in each group.The incidence of postoperative delirium,serum interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and central nervous system specific protein(S100-β)were compared between the two groups;Logistic regression model was used to analyze the univariate and multivariate factors affecting postoperative delirium.Results The incidence of postoperative delirium in group G was 23.84%,which was higher than that in group L(17 cases,13.08%),and the difference was statistically significant;Serum IL-6,TNF-α and S100-β 3d after operation in the two groups were significantly higher than those before operation;There was no significant difference in IL-6,TNF-α and S100-β 3d after operation between the two groups;The pr-eoperative MMSE score of patients with postoperative delirium was lower than that of patients without delirium,ASA grade,op-eration time,postoperative VAS score,IL-6,TNF-α And S100-β,proportion of elderly people were higher or longer than those in patients without delirium after operation;Logistic univariate analysis results:ASA classification,preoperative MMSE score,operation time,postoperative IL-6,TNF-α,S100-β,Anesthesia method,advanced age was related to postoperative delirium;Logistic multivariate analysis results:anesthesia mode(general anesthesia),preoperative MMSE score,postoperative IL-6,TNF-α And S100-β It was a risk factor for postoperative delirium.Conclusion Postoperative delirium in elderly patients and anesthesia methods,preoperative MMSE score,postoperative serum IL-6,TNF-α And S100-β,advanced age was monitoring the above factors can provide reference for the prevention and treatment of postoperative delirium.

old agepostoperative deliriuminterleukin-6tumor necrosis factor-αsoluble protein-100βrelativity

姚毅真、唐俊、郑钰琪、王芳、李妍妍

展开 >

复旦大学附属上海市第五人民医院麻醉科,上海 200240

老年 术后谵妄 白细胞介素-6 肿瘤坏死因子α 中枢神经特异蛋白 相关性

2024

湖南师范大学学报(医学版)
湖南师范大学

湖南师范大学学报(医学版)

CSTPCD
影响因子:1.389
ISSN:1673-016X
年,卷(期):2024.21(5)