老年脊柱结核患者术后发生认知功能障碍的危险因素及干预对策OA

Objective To explore the risk factors and intervention strategies for postoperative cognitive dysfunction(POCD)in elderly patients with spinal tuberculosis(STB).Methods A total of 80 elderly STB patients who were admitted in the First Affiliated Hospital of Xinxiang Medical College from October 2020 to February 2023 were selected.The incidence of postoperative POCD was statistically analyzed,and univariate analysis and multivariate logistic regression analysis were conducted to identify the risk factors for postoperative POCD in elderly STB patients.Results Among the 80 elderly STB patients,16 experienced postoperative POCD,with incidence rate was 20.00%(16/80).Compared with the non POCD group,the proportion of education level in junior high school and below,hospital stay≥10 days,visual analogue scale(VAS)score≥4 points at 1 day after surgery,diabetes,lowest intraoperative regional cerebral oxygen saturation(rSO2)＜60%,and rSO2＜60%for more than 30 minutes in the POCD group was higher,with a statistically significant difference(P＜0.05).Logistic multifactor analysis showed that education level of junior high school and below(OR=1.895),length of stay≥10 d(OR=2.513),VAS score≥4 at 1 day after surgery(OR=2.376),diabetes(OR=1.968),lowest rSO2＜60%(OR=4.205)during surgery,and duration of rSO2 below 60%＞30 min(OR=5.031)were independent risk factors for POCD in elderly STB patients,with a statistically significant difference(P＜0.05).Conclusion Education level,length of stay,VAS score at 1 day after surgery,diabetes,the lowest rSO2 during operation,and the duration of rSO2 below 60%are closely related to POCD in elderly STB patients after operation.Professional intervention measures should be implemented in clinical practice to reduce POCD.