目的 了解年齡與激素對重癥監護病房(intensive care unit,ICU)患者術后并發精神障礙的影響.
方法 以2001年8月至2004年1月解放軍總醫院ICU收治的388例術后患者為研究對象,調查ICU術后精神障礙的發生情況.針對"ICU患者中老齡和單次使用大劑量激素是否是術后發生精神障礙的主要危險因素"提出問題,以主題詞"postoperative cognitive confusion"和"intensive care"檢索MEDLINE(1968～2004),尋找相關證據.
結果 388例患者中術后并發精神障礙10例,占3.1%,其中9例為≥65歲的老年患者,占90%.本組ICU老年患者(≥65歲)術后精神障礙的發病率為6.6 %(9/136),≤65歲的患者為0.4 %(1/252),表明老年患者發病率較高(P＜0.05).單次使用甲基強的松龍≥1 000 mg的患者發病率為7.0 %(5/71),而單次使用甲基強的松龍＜1 000 mg的患者發病率為1.6 %(5/317),提示激素用量大的患者發病率較高(P＜0.05).
結論 結合文獻檢索回顧, ICU患者中老齡和單次使用大劑量激素是術后并發精神障礙的主要危險因素之一.
引用本文：
周飛虎,宋青,何蕾,馬迎民,潘亮,謝菲. 年齡與激素對ICU患者術后并發精神障礙的影響. 中國循證醫學雜志, 2004, 04(10): 734-736. doi:
復制
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- 1. ［1］Abildstrom H, Rasmussen LS, Rentowl P, Hanning CD, Rasmussen H, Kristensen PA, Moller JT. Cognitive dysfunction 1-2 years after non-cardiac surgery in the elderly ISPOCD group. International Study of Post-Operative Cognitive Dysfunction [J]. Acta Anaesthesiol Scand, 2000; 44(10): 1 246-1 251.
- 2. ［2］Dijkstra JB, Jolles J. Postoperative cognitive dysfunction versus complaints: a discrepancy in long-term findings [J]. Neuropsychol Rev, 2002; 12(1): 1-14.
- 3. ［3］Johnson T, Monk T, Rasmussen LS. Postoperative cognitive dysfunction in middle-aged patients [J]. Anesthesiology, 2002; 96(6): 1 351-1 357.
- 4. ［4］Rasmussen LS, Moller JT. Central nervous system dysfunction after anesthesia in the geriatric patient [J]. Anesthesiol Clin North America, 2000; 18(1): 59-70.
