潘秋宁　宣懂　林智　李志丹　王竹　陈文荣

【摘要】 目的：探究老年髋部骨折患者术后精神障碍的影响因素以及应对措施。方法：回顾分析2010年1月-2015年6月本院收治因髋部骨折行手术治疗的老年患者250例的临床资料，根据术后是否并发精神障碍分为精神障碍组（n=60）和非精神障碍组（n=190）。统计患者的基础资料及并发症情况，分析精神障碍发病的影响因素。结果：精神障碍组年龄、并发慢性阻塞性肺疾病和进行全身麻醉的比例均高于非精神障碍组，且血红蛋白浓度和血钠水平均低于非精神障碍组，比较差异均有统计学意义（P<0.05）；Logistic回归分析显示，年龄、血钠含量、血红蛋白浓度、术后并发慢性阻塞性肺疾病以及全身麻醉均是影响患者术后发生精神障碍的危险因素（P<0.05）。结论：年龄、血钠含量、血红蛋白浓度、术后并发慢性阻塞性肺疾病以及全身麻醉均是老年髋部骨折患者术后发生精神障碍的危险因素，医护人员应在手术前后根据患者的实际情况制定合理的預防及治疗方案，防止术后出现精神障碍。

【关键词】 髋部骨折； 精神障碍疾病； 影响因素； 应对措施

Analysis of Influencing Factors and Countermeasures of Postoperative Mental Disorder in Elderly Patients with Hip Fracture after Operation/PAN Qiuning，XUAN Dong，LIN Zhi，et al.//Medical Innovation of China，2018，15（17）：0-021

【Abstract】 Objective：To analyze the influence factors and countermeasures of postoperative mental disorder in elderly patients with hip fracture.Method：The clinical data of 250 elderly patients with hip fracture treated in our hospital from January 2010 to June 2015 were retrospectively analyzed.According to postoperative mental disorders，they were divided into mental disorder group（n=60） and non-mental disorder group（n=190）.The basic data and complications of patients were statistically analyzed，and the influencing factors of mental disorders were analyzed.Result：The age，the proportion of chronic obstructive pulmonary disease and general anesthesia in mental disorder group were higher than those of non-mental disorder group，and the hemoglobin concentration and serum sodium level were lower than those of non-mental disorder group，the differences were statistically significant（P<0.05）.Logistic regression analysis showed that age，blood sodium，hemoglobin concentration，complicated with chronic obstructive pulmonary disease and general anesthesia were risk factors for postoperative mental disorders（P<0.05）.Conclusion：Age，blood sodium，hemoglobin concentration，complicated with chronic obstructive pulmonary disease and general anesthesia may be risk factors are all risk factors for the onset of mental disorders in the elderly patients with hip fractures，and doctors and nurses should formulate reasonable prevention and treatment programs in accordance with the actual conditions of the patients before and after the operation to prevent mental disorders after the operation.

【Key words】 Hip fracture； Mental disorder； Influence factor； Countermeasures

First-authors address：Central Peoples Hospital of Zhanjiang，Zhanjiang 524045，China

doi：10.3969/j.issn.1674-4985.2018.17.005

随着社会的发展，我国老龄化人口数量呈现不断上升的趋势，然而老年人的身体功能则会随着年龄的增大而出现不断退化的现象。有研究表明，由骨质降低导致的骨痛和脆性骨折一直是困扰老年人身体健康的重要因素[1-2]。髋部骨折是一种常见的、多发于老年人群的损伤性骨疾病，其发病率不断升高[3]。目前，手术治疗是老年髋部骨折治疗的常见方法，但术后容易发生下肢深静脉血栓、精神障碍等并发症[4-5]。Koskderelioglu等[6]研究发现，招募的109例老年人髋部骨折术后发生急性精神障碍的患者有20例，发生率约为18.3%。术后精神障碍（postoperative mental disorder）是指在术后数天内发生的一种可逆的和波动性的急性精神紊乱综合征，包括认知、意识、行为、定向、睡眠等方面的紊乱[7-8]。为了研究导致老年髋部骨折患者术后发生精神障碍的影响因素，本研究通过回顾性研究，分析了250例老年人髋部骨折术后发生精神障碍的危险因素，并根据分析结果提出有针对性的预防及应对措施。……