Study on independent risk factors and nursing countermeasures of cognitive dysfunction in elderly patients after radical gastrectomy for gastric cancer
老年病人胃癌根治术后认知功能障碍形成的独立危险因素及护理对策研究

摘要

目的 由于老年病人胃癌根治术后并发认知功能障碍风险较大，涉及危险因素较多，加强筛查术后认知功能障碍高危病人，对危险因素及护理对策作进一步探究，为临床提供参考依据。方法 研究筛选出共50例老年胃癌根治术病人为研究对象，于2020年1月至2021年12月进入本院治疗，采用一般资料量表调查基础信息，根据MMSE量表筛选出有认知功能障碍的病人，通过单因素分析、多因素Logistic回归分析老年病人胃癌根治术后认知功能障碍形成的独立危险因素，制定对应护理对策。结果 术后有认知功能障碍6例；单因素分析，危险因素有受教育程度、年龄、酗酒史、高血压病史、糖尿病病史、心脑血管疾病史、术中出血量、麻醉时间、术后1-7d，VAS评分、术前1d白蛋白；多因素Logistic 回归分析术后认知功能障碍形成的独立危险因素有年龄 ≥75岁、酗酒史、高血压病史、糖尿病病史、心脑血管疾病史、术中出血量≥500mL、术后1-7d，VAS评分≥4分。结论 通过加强对老年病人胃癌根治术后认知功能障碍高危病人的筛查，分析独立危险因素，为其实施针对性护理对策，其意义重大。

Abstract

Objective: Due to the high risk of cognitive dysfunction after radical gastrectomy for gastric cancer in elderly patients, there are many risk factors involved, so we should strengthen the screening of high-risk patients with postoperative cognitive dysfunction, further explore the risk factors and nursing countermeasures, and provide reference for clinical practice.
Methods: a total of 50 elderly patients undergoing radical gastrectomy for gastric cancer were selected as the research objects. They were treated in our hospital from January 2020 to December 2021. The basic information was investigated by the general data scale, and the patients with cognitive impairment were selected according to the MMSE scale. The independent risk factors of cognitive impairment in elderly patients after radical gastrectomy for gastric cancer were analyzed by univariate analysis and multivariate logistic regression, and the corresponding nursing countermeasures were formulated.
Results: 6 cases had cognitive dysfunction after operation; Univariate analysis showed that the risk factors included education level, age, alcohol abuse history, history of hypertension, history of diabetes, history of cardiovascular and cerebrovascular diseases, intraoperative bleeding volume, anesthesia time, 1-7 days after operation, VAS score, and albumin 1 day before operation; Multivariate logistic regression analysis showed that the independent risk factors for the formation of postoperative cognitive dysfunction were age ≥ 75 years old, history of alcohol abuse, history of hypertension, history of diabetes, history of cardiovascular and cerebrovascular diseases, intraoperative bleeding ≥ 500ml, 1-7d after operation, and VAS score ≥ 4 points.
Conclusion  : it is of great significance to strengthen the screening of elderly patients with cognitive dysfunction after radical gastrectomy, analyze independent risk factors, and implement targeted nursing countermeasures for them.