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术前C反应蛋白作为老年结肠癌患者腹腔镜手术后谵妄的危险因素

Preoperative C-Reactive Protein as a Risk Factor for Postoperative Delirium in Elderly Patients Undergoing Laparoscopic Surgery for Colon Carcinoma.

作者信息

Xiang Dong, Xing Hailin, Tai Huiyu, Xie Guozhu

机构信息

Department of Anesthesiology, Taizhou People's Hospital, Medical School of Nantong University, Taizhou, China.

Department of Intensive Care Unit, Taizhou People's Hospital, Medical School of Nantong University, Taizhou, China.

出版信息

Biomed Res Int. 2017;2017:5635640. doi: 10.1155/2017/5635640. Epub 2017 Oct 18.

Abstract

BACKGROUND

Postoperative delirium (POD) is a very common complication in operative disciplines, especially in those elderly patients after cardiac surgery. This study aimed to investigate the relationship between C-reactive protein (CRP) and POD in elderly patients undergoing laparoscopic surgery for colon carcinoma.

METHODS

160 elderly patients scheduled to undergo selective laparoscopic surgery for colon carcinoma were prospectively recruited in this present study. The preoperative demographic and medical characteristics, intraoperative variables, and postoperative complications were all recorded in detail. POD assessment was performed once a day for the first 3 days and at 7th day after surgery, respectively. CRP concentrations preoperatively and on postoperative days 1, 2, and 3 were measured by using human enzyme linked immunosorbent assay (ELISA).

RESULTS

Of all the 160 enrolled patients, 39 had suffered POD with a POD incidence of 24.4% within the first week after the operation. The univariate analysis and multiple logistic regression analysis suggested preoperative CRP concentrations as the only independent predicator for POD in patients undergoing laparoscopic surgery for colon carcinoma (OR: 5.87; 95% CI: 2.22-11.4; = 0.018).

CONCLUSIONS

This present study highlighted the predictive role of preoperative CRP concentrations for POD in elderly patients undergoing laparoscopic surgery for colon carcinoma.

摘要

背景

术后谵妄(POD)是手术科室中非常常见的并发症,尤其是在心脏手术后的老年患者中。本研究旨在探讨老年结肠癌患者行腹腔镜手术后C反应蛋白(CRP)与POD之间的关系。

方法

本研究前瞻性纳入了160例计划行选择性腹腔镜结肠癌手术的老年患者。详细记录术前人口统计学和医学特征、术中变量及术后并发症。术后前3天每天进行一次POD评估,术后第7天也进行评估。采用人酶联免疫吸附测定(ELISA)法测定术前及术后第1、2、3天的CRP浓度。

结果

在所有160例纳入患者中,39例发生POD,术后第一周内POD发生率为24.4%。单因素分析和多因素logistic回归分析表明,术前CRP浓度是老年结肠癌患者行腹腔镜手术后发生POD的唯一独立预测因素(OR:5.87;95%CI:2.22-11.4;P = 0.018)。

结论

本研究强调了术前CRP浓度对老年结肠癌患者行腹腔镜手术后发生POD的预测作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d72/5664269/f7ea831af150/BMRI2017-5635640.001.jpg

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