北京大学学报（医学版）2011，Vol.43Issue(2)：242-249,8.DOI:10.3969/j.issn.1671-167X.2011.02.016
冠状动脉旁路移植手术后早期谵妄与认知功能障碍的关系
Postoperative delirium is associated with cognitive dysfunction one week after coronary artery bypass grafting surgery
穆东亮 1王东信 1李立环 2单国瑾 1苏玉 1于钦军 2史春霞2
作者信息
- 1. 北京大学第一医院麻醉科,北京,100034
- 2. 中国医学科学院阜外心血管病医院麻醉科,北京,100037
- 折叠
摘要
Abstract
Objective : To investigate the relationship between postoperative delirium ( POD) and postoperative cognitive dysfunction ( POCD ) after coronary artery bypass graft in Chinese population. Methods: One hundred and seven patients who were referred for elective coronary artery bypass grafting ( CABG) surgery were enrolled in this prospective cohort study. Baseline and perioperative variables as well as occurrence of postoperative complications were recorded. POD was diagnosed using the Confusion Assessment Method for the Intensive Care Unit twice daily during the first seven postoperative days. A neuropsychological test battery that included 7 tests with 9 subscales was administered at baseline and on the seventh day after surgery. POCD was defined using the same definition that was used in the ISPOCD1 study. Results: The incidence of POD was 47. 7％ (51/107 ) while that of POCD was 55. 3％ (57/ 103 ) . Multivariate Logistic regression analyses identified four independent risk factors of POD , i. e. , increasing age ( OR 1. 174 , 95％ CI 1. 085 - 1. 269 , P ＜0. 001) , preoperative history of diabetes mellitus ( OR 4. 224, 95％ CI 1. 543 - 11. 563, P = 0. 005 ) , occurrence of postoperative complications ( OR 3. 667, 95％ CI 1. 152 - 11. 670, P =0. 028) , and prolonged duration of intensive care unit stay ( OR 1. 024, 95％ CI 1. 005 - 1. 044, P = 0. 016) . And two independent risk factors of POCD were identified, i. e. , increasing age ( OR 1. 065 , 95％ CI 1. 001 - 1. 134, P =0. 047) and prolonged duration of POD ( OR 1. 744 , 95％ CI 1. 173 -2. 593 , P =0. 006) . Conclusion: POD and POCD are common cognitive complications after CABG surgery in Chinese population. Prolonged duration of POD is an independent risk factor of the occurrence of POCD.关键词
冠状动脉分流术/谵妄/认知障碍/手术后并发症/危险因素分类
医药卫生引用本文复制引用
穆东亮,王东信,李立环,单国瑾,苏玉,于钦军,史春霞..冠状动脉旁路移植手术后早期谵妄与认知功能障碍的关系[J].北京大学学报（医学版）,2011,43(2):242-249,8.
