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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1王粉山1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例正常老年人在随访过程中有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;同时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(p<0.05);年龄、糖尿病、术中缺氧时间、术中
2、术后低血压时间与术后记忆功能障碍呈正相关(r=0.685,p=0.012;r=0.512,p=0.034;r=0.675,p=0.007;r=0.589,p=0.004);正常老年人术后,其认知功能有损害,尤其是记忆功能(p<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、术中缺氧时间、术中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、unityLi-weixing1Zhang-ping1Wang-fenshan1Zhang-min2(1CenterhospitalofchangSonginjiangsu,2People'shospitalofjiangduinjiangsu)AbstractObjectiveTostudythecharacteristicsofpostoperativecognitivefunctionandinfluencingfactors,MethodAssessmentwithMMSEof40casesofnon-cardiac
4、anesthesiaforelectivesurgeryofelderlyand90casesofnormalcognitivefunctionofolderpersons,comparedcognitivedifferences;inthedurationoffollowup,19normalelderlydidnon-regularnon-cardiacsurgery,comparetheirpre-surgeryandpostoperativecognitivefunctionchange;analysisofelde
5、rlypatientstheriskfactorsofcognitivedysfunction.ResultComparedwiththehealthyelderly,theelderlyofpostoperativehadmoredamageofcognitivefunction.Especiallymemory,attentionandcalculationability(p<0.05);Age,diabetes,ischemictimeofsurgery,postoperativehypotensiontimeandm
6、emorydysfunctionafterpositivecorrelation(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).ConclusionsTheelderlyofpostoperativehadmoredamageofcognitivefunction,espec
7、iallymemory,attentionandcalculationability.Therewerepositivecorrelationwithcognitivedysfunctionintheage,diabetes,ischemictimeofsurgery,postoperativehypotensiontime.Keywords:communitycognitivefunctionpostoperativecognitivedisfunction术后认知功能障碍(postoperativecognitivedi
8、sfunction,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、康复时间及自理能力,目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