老年患者腹部手术术前血红蛋白水平与术后谵妄发生的关系

摘要/Abstract

摘要： 目的探讨与分析老年患者腹部手术术前血红蛋白水平与术后谵妄发生的关系。方法回顾性选择2021年8月~2022年3月在宁夏医科大学总医院进行腹部手术的216例老年患者作为研究对象,依据是否发生谵妄分为谵妄组（n=32）与非谵妄组（n=184）。调查与记录所有患者的一般资料,包括性别、年龄、麻醉ASA分级、麻醉时间、手术时间、术中出血量、空腹血糖、白蛋白等。所有患者在术前1 d和术后当天检测血红蛋白水平。术后采用谵妄评估量表（CAM）评估患者的谵妄发生情况并采用Pearson分析进行相关性分析,影响因素分析采用多因素Logistic逐步回归分析,预测价值分析采用ROC曲线分析。结果谵妄组的性别、年龄、麻醉ASA分级、麻醉时间、手术时间、术中出血量、白蛋白与非谵妄组比较,差异无统计学意义（P>0.05）。谵妄组术前1 d的血红蛋白水平明显少于非谵妄组,差异有统计学意义（P<0.05）。在216例患者中,Pearson分析显示术前1 d血红蛋白水平与术后5 d谵妄的发生存在相关性（P<0.05）。多因素Logistic逐步回归分析显示,术前1 d血红蛋白水平为导致术后5 d谵妄发生的重要影响因素（P<0.05）。受试者工作特征（ROC）曲线分析显示,术前1 d血红蛋白水平预测术后5 d谵妄发生的曲线下面积为0.670。结论腹部手术老年患者术后容易发生谵妄,术前血红蛋白水平与术后谵妄发生存在正相关性,也为导致谵妄发生的重要因素,也可预测术后谵妄的发生。

关键词: 老年人, 谵妄, 血红蛋白, 腹部手术, 相关性, 影响因素, 预测价值

Abstract: Objective To explore and analysis the relationship between preoperative hemoglobin level and postoperative delirium in elderly patients undergoing abdominal surgery. Methods From August 2021 to March 2022, 216 elderly patients who underwent abdominal surgery in the General Hospital of Ningxia Medical University were retrospective selection as the research subjects. According to whether delirium occurred, they were divided into delirium group(n=32) and non-delirium group(n=184). Investigate and record the general information of all patients, including gender, age, anesthesia ASA classification, anesthesia time, operation time, intraoperative blood loss, fasting blood glucose, albumin, etc. The hemoglobin levels were monitored in all patients 1 day before surgery and the day after surgery. Postoperative delirium was assessed by the Confusion Assessment Method(CAM), and Pearson analysis was used for correlation analysis. Multivariate Logistic stepwise regression analysis was used for influencing factor analysis, and ROC curve analysis was used for predictive value analysis. Results There was no significant difference in sex, age, ASA grade, anesthesia time, operation time, intraoperative bleeding and albumin compared between delirium group and non delirium group (P>0.05). The hemoglobin level of delirium group was significantly lower than that of non delirium group (P<0.05). In the 216 patients, Pearson analysis showed that there was correlation between hemoglobin level on the 1st day before operation and delirium on the 5th day after operation (P<0.05). Multivariate logistic stepwise regression analysis showed that the level of hemoglobin 1 day before operation was an important factor leading to delirium 5 days after operation (P<0.05). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve of hemoglobin level 1 day before operation to predict delirium 5 days after operation was 0.670. Conclusion Elderly patients with abdominal surgery are prone to postoperative delirium. There is positive correlation between preoperative hemoglobin level and postoperative delirium. It is also an important factor leading to delirium and can also predict the occurrence of postoperative delirium.

Key words: elderly patients, delirium, hemoglobin, abdominal surgery, relevance, influencing factors, predictive value

中图分类号:

R614

赵万里, 倪新莉. 老年患者腹部手术术前血红蛋白水平与术后谵妄发生的关系[J]. 中华养生保健, 2022, 40(18): 19-21.

ZHAO Wan-li, NI Xin-li. Relationship between Preoperative Hemoglobin Level and Postoperative Delirium in Elderly Patients Undergoing Abdominal Surgery[J]. ZHONGHUA YANGSHENG BAOJIAN, 2022, 40(18): 19-21.

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