Volume 19 Issue 6
Jun.  2021
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Article Navigation >  Chinese Journal of General Practice  > 2021  >  19(6): 944-946,968
WANG Shun, WAN Hai-fang, NI Yan-hua. Effect of pressure controlled ventilation on postoperative delirium in elderly patients with spinal tuberculosis[J]. Chinese Journal of General Practice, 2021, 19(6): 944-946,968. doi: 10.16766/j.cnki.issn.1674-4152.001956
Citation: WANG Shun, WAN Hai-fang, NI Yan-hua. Effect of pressure controlled ventilation on postoperative delirium in elderly patients with spinal tuberculosis[J]. Chinese Journal of General Practice, 2021, 19(6): 944-946,968. doi: 10.16766/j.cnki.issn.1674-4152.001956
shu

Effect of pressure controlled ventilation on postoperative delirium in elderly patients with spinal tuberculosis

doi: 10.16766/j.cnki.issn.1674-4152.001956
  • 1.

    Department of Anesthesiology, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003,China

Funds:

 2019KY508

  • Received Date: 2020-05-08
    Available Online: 2022-02-16
    Abstract
  •   Objective  To explore the effect of pressure-controlled ventilation (PCV) mode on postoperative delirium (POD) in elderly patients with spinal tuberculosis.  Methods  A total of 72 elderly patients suffering from spinal tuberculosis and admitted to a hospital from September 2018 to September 2019 were included in the study. They were randomly divided into observation and control groups with a simple random number table method, and each group contained 36 patients. Patients in the observation group received PCV mode ventilation [initial parameters: VT=8 mL/kg, oxygen flow=2 L/min, RR=12 times/min, FiO2=60%, I∶E=1∶1.5. FiO2; were maintained during the operation; I∶E was unchanged, VT was adjusted to 6 mg/kg+5 cm H2O (1 cm H2O=0.098 kPa) and PetCO2 was maintained at 33-36 mm Hg (1 mm Hg=0.133 kPa) level). The control group received conventional positive pressure ventilation (VT=8 mL/kg, RR=12 times/min, I∶E=1∶2, PEEP=0 cm H2O). Within 1 week after surgery, the rate of postoperative delirium in both groups was evaluated with the consciousness confusion assessment method. For patients with POD after symptomatic treatment, no case of death due to POD was recorded, and the outcome of delirium in the two groups was analysed.  Results  The incidence rate of POD in the observation group was 19.44%(7/36), lower than that in the control group (41.67%, 15/36). The difference was statistically significant (χ2=4.189, P=0.041). POD continued despite that the time was shorter than that in the control group, and the difference was not statistically significant (t=1.504, P=0.137). The POD outcome of the observation group was better than that of the control group, and the difference was statistically significant (Z=-2.799, P=0.005). The outcome of the observation group was 100.00% (7/7), better than that of the control (53.33%, 8/15). Statistically significant differences were found (χ2=4.791, P=0.029).  Conclusion  Pressure control ventilation during the operation of elderly patients with spinal tuberculosis can help reduce the incidence of postoperative delirium and increase the postoperative delirium outcome rate and is thus suitable for clinical application.

     

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    • References(15)
  • [1]
    SOH S, SHIM J K, SONG J W, et al. Postoperative delirium in elderly patients undergoing major spinal surgery: role of cerebral oximetry[J]. J Neurosurg Anesthesiol, 2017, 29(4): 426-432. doi: 10.1097/ANA.0000000000000363
    [2]
    CHRISINGER A A, CHENG J Z, MUENCH M R, et al. Ability of postoperative delirium to predict intermediate-term postoperative cognitive function in patients undergoing elective surgery at an academic medical centre: protocol for a prospective cohort study[J]. BMJ Open, 2018, 8(3): e017079. doi: 10.1136/bmjopen-2017-017079
    [3]
    李丽琴, 孙艳丽, 王聪, 等. 老年患者术后谵妄防治的研究进展[J]. 国际老年医学杂志, 2019, 40(1): 59-64. doi: 10.3969/j.issn.1674-7593.2019.01.017
    [4]
    陈刚. 中老年脊柱手术患者发生谵妄的危险因素Logistic回归分析[J]. 颈腰痛杂志, 2019, 40(3): 329-331. doi: 10.3969/j.issn.1005-7234.2019.03.012
    [5]
    黄清奇, 刘少强, 梁珪清. 脊柱手术患者术后谵妄的危险因素及临床防治研究进展[J]. 中华外科杂志, 2019, 57(6): 476-480.
    [6]
    刘键, 李明东, 王先安, 等. 老年脊柱结核手术并发症的原因分析及处理[J]. 国际老年医学杂志, 2018, 39(4): 168-171, 198. doi: 10.3969/j.issn.1674-7593.2018.04.005
    [7]
    戴传强, 吴向东, 程强, 等. 老年骨科大手术患者术后谵妄危险因素的研究进展[J]. 四川医学, 2019, 40(6): 641-644. https://www.cnki.com.cn/Article/CJFDTOTAL-SCYX201906024.htm
    [8]
    汪悦, 李娟. 老年患者术后谵妄的危险因素分析及其临床防治现状[J]. 国际麻醉学与复苏杂志, 2018, 39(3): 239-244, 249. doi: 10.3760/cma.j.issn.1673-4378.2018.03.010
    [9]
    NUMAN T, BOOGAARD M V D, KAMPER A M, et al. Recognition of delirium in postoperative elderly patients: A multicenter study[J]. J Am Geriatr Soc, 2017, 65(9): 1932-1938. doi: 10.1111/jgs.14933
    [10]
    王玉强, 刘屹林, 张敏, 等. 谵妄预测模型在高龄骨科手术患者中的初步建立及有效性验证[J]. 中华创伤骨科杂志, 2019, 21(7): 558-563. doi: 10.3760/cma.j.issn.1671-7600.2019.07.002
    [11]
    SHIN Y H, YOON J S, JEON H J, et al. Postoperative delirium in elderly patients with critical limb ischemia undergoing major leg amputation: A retrospective study[J]. Korean J Anesthesiol, 2018, 71(4): 311-316. doi: 10.4097/kja.d.18.27108
    [12]
    王明帅, 杨永涛, 范正洋, 等. 老年患者脊柱术后谵妄的危险因素分析[J]. 临床骨科杂志, 2019, 22(1): 15-18. doi: 10.3969/j.issn.1008-0287.2019.01.007
    [13]
    李伟, 罗江洪. 老年脊柱手术术后谵妄发生率及高危因素分析[J]. 颈腰痛杂志, 2018, 39(5): 584-586. https://www.cnki.com.cn/Article/CJFDTOTAL-JYTZ201805014.htm
    [14]
    陈惠英, 黄德辉, 刘衬云, 等. 容量控制通气与压力控制通气对老年肺癌肺叶切除术患者血流动力学影响的对比研究[J]. 中国临床医生杂志, 2017, 45(12): 70-72. doi: 10.3969/j.issn.2095-8552.2017.12.025
    [15]
    王玉, 王清秀, 张清. 压力控制容量通气对行脊柱手术的临床效果及血流动力学的影响[J]. 中国医学装备, 2018, 15(11): 105-108. doi: 10.3969/J.ISSN.1672-8270.2018.11.029
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