A型主动脉夹层患者术后谵妄危险因素的分析与对策
Regression analysis of risk factors for postoperative delirium in patients with type A aortic dissection
李艳鑫 1何慧 1肖长波 1张亚飞 1王玉伟 1李雪莉1
作者信息
- 1. 河南省胸科医院心血管外科,郑州 450008
- 折叠
摘要
目的 经二元logistics回归分析A型主动脉夹层(a aortic dissection,AAD)患者术后谵妄的危险因素,并探讨其对策.方法 回顾性分析2022年10月至2023年12月于河南省胸科医院接受手术治疗的186例AAD患者,统计患者术后谵妄发生情况,并将其分为谵妄组与无谵妄组,对比两组临床资料,分析AAD患者术后谵妄的危险因素.结果 186例AAD患者术后发生谵妄72例,占38.71％;谵妄组有脑卒中史、电解质紊乱、急性肾衰竭占比高于无谵妄组(x2=5.866、8.014、9.065、10.407,P＜0.05);经logistic回归分析,结果显示,脑卒中史(OR=7.000)、电解质紊乱(OR=4.360)、急性肾衰竭(OR=3.606)、纤维蛋白原＜2 g/L(OR=3.728)是AAD患者术后发生谵妄的危险因素(OR＞1,P＜0.05).结论 AAD患者术后谵妄的发生可能与脑卒中史、电解质紊乱、急性肾衰竭、纤维蛋白原降低有关,临床应关注存在上述因素的患者,早期实施相关干预措施,以降低术后谵妄发生率.
Abstract
Objective To analyze the risk factors of postoperative delirium in patients with type A aortic dissection(AAD)by binary logistics regression,and discuss the countermeasures.Methods A total of 186 patients with AAD who underwent surgical treatment in Henen Chest Hospital from October 2022 to December 2023.The incidence of postopera-tive delirium was counted and divided into delirium group and non-delirium group.The clinical data of the two groups were compared to analyze the risk factors of postoperative delirium in patients with AAD.Results Postoperative delirium occurred in 72 of 186 patients with AAD,accounting for 38.71％;the delirium group had a history of stroke,electrolyte disorders,and a higher proportion of acute renal failure compared to the non delirium group(x2=5.866,8.014,9.065,10.407,P＜0.05);logistic regression analysis showed that stroke history(OR=7.000),electrolyte disturbance(OR=4.360),acute renal failure(OR=3.606)and fibrinogen＜2 g/L(OR=3.728)were risk factors for postoperative de-lirium in patients with AAD(OR＞1,P＜0.05).Conclusion The occurrence of postoperative delirium in patients with AAD may be related to the history of stroke,electrolyte disorder,acute renal failure and decreased fibrinogen.Clinicians should pay attention to patients with the above factors and implement relevant intervention measures early to reduce the incidence of postoperative delirium.
关键词
A型主动脉夹层/术后谵妄/危险因素/对策Key words
Type A aortic dissection/Postoperative delirium/Risk factors/Counter-measure引用本文复制引用
基金项目
河南省医学科技攻关计划联合共建项目(LHGJ20220231)
出版年
2024
NETL
NSTL
万方数据