老年患者术后认知功能障碍的研究

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1、提要目的：探讨老年骨科手术患者术后认知功能障碍(POCD)的危险因素。分析引起骨科高龄患者术后认知功能障碍的原因,并找出防治方法及措施。方法：选择山东中医药大学附属医院骨外科病房择期行骨科手术且年龄>60岁的老年病人50例，使用神经心理学测试量表评估患者术前术后认知功能，分析术后认知功能障碍发生的影响因素；采用SPSSl1.5统计软件进行数据分析，其中对影响因素分析采用Logistic逐步回归分析。结果：年龄、术前合并高血压和术前抑郁与术后认知功能障碍发生有显著性关系，有统计学意义(P<0.05)；结论：骨科老年患者术后认知功能障碍发病率高，危害大，应该引起骨科同仁的重视，术前要充分准

2、备，术后要及时纠正各种生理紊乱，进行心理疏导，加强护理。年龄、术前合并高血压和抑郁是与老年患者术后认知功能障碍发生有关的影响因素，通过围手术期对骨科手术治疗中的老年患者施行心理干预可以有效减少老年患者术后认知功能障碍的发生，使老年患者在术后认知功能的各个方面得以改善。关键词老年人骨科术后认知功能障碍TheStudyofPostoperativeCognitiveDysfunctioninElderlyPatientsAbstractSpeciality:OrthopedicsofChineseMedicineAuthor:WangjinsongTutor:Professor.WangM

3、ingxiAbstractObjective:Toinvestigatefactorsoftheelderlypatientsbeingaffectedbythecognitivedysfunction(POCD)afterorthopaedicsurgery.ToanalyzefactorsthatleadstoPOCDandworkoutmethodstopreventandmeasurewithit.Methods:Choose50elderlypatientsthatareovertheageof60whichhavedoneorthopaedicsurgeryinShando

4、ngtraditionalChinesemedicinehospital,orthopedicsward,testthecognitivefunctionofthepatientbeforeandafterthesurgeryusingneuropsychologicaltestingscale,analyzethecontributivefactorsofPOCD;doingdataanalysiswithSPSS11.5statisticsoftware,andtakelogisticstepwiseregressionanalysistoanalyzethecontributiv

5、efactors.Results:Age,preoperativehypertension,andpreoperativedepressionhaveobviousimpactonPOCD,whichhasstatisticsense(P<0.05).Conclusion:TheincidenceofPOCDattackingtheelderlyorthopaedicpatientsishighandtheharmisserious,whichtheorthopaediccolleaguesshouldpayhighattentiontoanddoabundantpreparation

6、beforethesurgery.ItisalsoessentialtocorrectPhysiologicaldisorders,dopsychologicalcounselingandstrengthennursingcareafterthesurgery.Age,preoperativehypertension,andpreoperativedepressionarethecontributivefactorsofPOCD,whichcanbepreventbydoingpsychologicalcounselingtotheelderlypatientsthataretakin

7、gabdominalsurgicaloperationtreatmentduringperioperativeperiodandthereforeimproveallareasofthecognitivefunctionoftheelderlypatientsaftersurgery.KeyWordPostoperativecognitivedysfunction；Elderlypatient；Departmentoforthopedics目录