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1、社区术后老年人认知功能状况的临床观察李卫星1张平I王粉山I张敏2(1江苏省江都市昌松中心卫生院，2江苏省江都市人民医院)摘要目的探讨术后老年人认知功能特点和影响因素，方法采用MMSE评估40例非心脏非全麻择期手术老年人和90例正常老年人的认知功能，比较其认知差异；60例止常老年人在随访过程屮有19例行非心脏非全麻择期手术，比较其术前与术后认知功能变化；同吋分析术后老年人认知功能障碍相关危险因素，结果与正常老年人相比，术后老年人出现多认知领域损害，尤其是记忆功能、注意和计算能力(/K0.05)；年龄、糖尿病、术屮缺氧吋
2、间、术屮术后低血压吋间与术后记忆功能障碍呈正相关(厂0.685,尸0.012；厂0.512,^0.034；厂0.675,尸0.007；7-0.589,尸0.004)；正常老年人术后，其认知功能有损害，尤其是记忆功能(氏0.05)。结论术后老年人认知功能有多领域障碍，尤其是记忆力和注意计算力，而年龄、糖尿病、术屮缺氧时间、术屮术后低血压时间与术后老年人认知功能障碍有关。关键词：社区认知术后认知功能Observationofthepostoperativecognitivefunctionintheelderlycomm
3、unity111oLi-weixingZhaWang-fenshanZhang-mirT(1CenterhospitalofchangSonginjiangsu,2People'shospitalofjiangduinjiangsu)AbstractObjectiveTostudythecharacteristicsofpostoperativecognitivefunctionandinfluencingfactors,MethodAssessmentwithMMSEof40casesofnon-cardiacan
4、esthesiaforelectivesurgeryofelderlyand90casesofnormalcognitivefunctionofolderpersons,comparedcognitivedifferences;inthedurationoffollowup,19normalelderlydidnon-regularnon-cardiacsurgery,comparetheirpre-surgeryandpostoperativecognitivefunctionchange;analysisofel
5、derlypatientstheriskfactorsofcognitivedysfunction・ResultComparedwiththehealthyelderly,theelderlyofpostoperativehadmoredamageofcognitivefunction.Especiallymemory,attentionandcalculationability(p<0.05);Age,diabetes,ischemictimeofsurgery,postoperativehypotensionti
6、meandmemorydysfunctionafterpositivecorrelation(r=0.685,p=0.012;r=0.512,p=0.034;r=0.675,p=0.007;r=0.589,p=0.004);Postoperativeofnormalelderlypatients,thecognitiveimpairedisthememoryfunction(p<0.05).ConclusiorisTheelderlyofpostoperativehadmoredamageofcognitivefun
7、ction,especiallymemory,attentionandcalculationability.Therewerepositivecorrelationwithcognitivedysfunctionintheage,diabetes,ischemictimeofsurgery,postoperativehypotensiontime.Keywords:communitycognitivefunctionpostoperativecognitivedisfunction术后认知功能障碍(postopera
8、tivecognitivedisfunction,POCD)是麻醉手术后老年人常见的神经系统并发症【1】，主要表现为记忆力、注意力等认知损害。有研究显示，老年患者术后一•周的发病率达到29.6%[2],可延长其住院、康复吋间及自理能力，H前尚缺乏有效的治疗方法。本研究通过MMSE评估术后老年人认知功能情况，及相关危险因素，为早期识别，早期干预提
