患者自控静脉镇痛引起术后认知功能障碍的病例对照研究

谭文斐; 赵芸慧; 方波; 马虹; 王俊科

文章摘要

谭文斐,赵芸慧,方波,马虹,王俊科.患者自控静脉镇痛引起术后认知功能障碍的病例对照研究[J].中华流行病学杂志,2008,29(2):188-190

患者自控静脉镇痛引起术后认知功能障碍的病例对照研究

A case-control study on the risk factors in postoperative cognitive dysfunction induced by patient selfcontrolled intravenous analgesia

收稿日期:2007-09-20 出版日期:2014-09-18

DOI：

中文关键词: 患者自控静脉镇痛术后认知功能障碍危险因素

英文关键词: Patient control intravenous analgesia Postoperative cognitive dysfunction Risk factors

基金项目:国家“九五”科技攻关课题资助项目(96-906-02-05)

作者	单位	E-mail
谭文斐	中国医科大学附属第一医院麻醉科, 沈阳 110001	xudezh@fmmu.edu.cn
赵芸慧	中国医科大学附属第一医院麻醉科, 沈阳 110001
方波	中国医科大学附属第一医院麻醉科, 沈阳 110001
马虹	中国医科大学附属第一医院麻醉科, 沈阳 110001
王俊科	中国医科大学附属第一医院麻醉科, 沈阳 110001

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中文摘要:

目的探讨患者自控静脉镇痛(PCIA)引起术后认知功能障碍(POCD)的危险因素.方法应用Mini-Mental-State(MMS)方法测试认知功能,以年龄、性别、术式、PCIA总量为匹配条件,对择期行骨科手术的全麻病例POCD组103例和未发生POCD组103例进行1:1配对病例对照研究.采用SPSS 11.5统计软件进行有关统计学分析.结果单因素分析显示,脑外伤史、受教育程度、VAS评分低于5分的例数在两组之间的差异有统计学意义;多因素分析证实,脑外伤史、VAS评分、受教育程度与PCIA引起POCD显著相关,OR值(95%CI)分别为4.261(1.344～13.508)、2.364(1.209～4.624)和0.312(0.170～0.573).结论 PCIA引起POCD相关的危险因素为曾经有过脑外伤史、VAS评分低下,而受教育程度高可能是其保护因素.

英文摘要:

objective To investigate the risk factors in postoperative cognitive dysfunction(POCD) induced by patient self-controlled intravenous analgesia (PCIA).Methods A case-control sfudy included 103 patients with POCD(P group),assessed by Mini-Mental-State test and 103 cognitive normal controls (NP group).The cases and controls were matched for age, gender, history of operation and PCIA volume dose.The relationship between POCD and various factors was analyzed by univariate and multivariate analysis.Spss 11.5 of statistical software was used for data analysis.Results Data from univariate analysis showed that the history of cerebral trauma, education level and VAS score had significant differences between P group and NP group.Multivariate analysis conformed that the history of cerebral trauma, VAS score and education level were significantly related to POCD induced by PCIA and their ORs(95% Cl) were 4.261(1.344- 13.508),2.364(1.209- 4.624),0.312(0.170-0.573)respectively.Conclusion Patient's history of cerebral trauma and low VAS score were independent risk factors of POCD induced by PCIA and high education level seemed to be a protective factor.

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