张立智;张世民;

• 1:同济大学附属杨浦医院骨科
• 2:上海市杨浦区中心医院

摘要(Abstract)：

<正>谵妄(delirium)是注意力和认知功能的急性可逆性障碍,常见于身体衰退的老年人。Smith等[1](2013)对1 077例老年髋部骨折患者研究发现,谵妄是术后最常见的并发症,发生率达44%。Rudolph等[2](2011)对以往的研究文献进行综合分析后,发现老年髋部骨折术后谵妄的发生率在35%~65%之间。谵妄可由多种原因引起,常以意识状态的急性改变或反复波动、注意力缺损、思维紊乱和意识模糊为特征。谵妄延长了髋部骨折老年人术后的住院时间,

关键词(KeyWords)： 老年人;髋部骨折;手术;谵妄

Abstract:

Keywords:

基金项目(Foundation): 上海市卫生局局级课题项目资助(编号:20124303);; 上海市自然科学基金资助(13ZR1439100)

作者(Author): 张立智;张世民;

Email:

DOI:

参考文献(References)：

• [1]Smith T,Hameed Y,Cross J,et al.Assessment of people with cognitive impairment and hip fracture:as ystematic review and meta-analysis[J].Arch Gerontol Geriatr,2013,57:117-126.
• [2]Rudolph JL,Marcantonio ER.Review articles:postoperative delirium:acute change with long-term implications[J].Anesth Analg,2011,112:1202-1211.
• [3]van Gool WA,van de Beek D,Eikelenboom P.Systemic infection and delirium:when cytokines and acetylcholine collide[J].Lancet,2010,375:773-775.
• [4]Slor CJ,Adamis D,Jansen RW,et al.Delirium motor subtypes in elderly hip fracture patients:risk factors,outcomes and longitudinal stability[J].J Psychosom Res,2013,74:444-449.
• [5]Lee HB,Mears SC,Rosenberg PB,et al.Predisposing factors for postoperative delirium after hip fracture repair in individuals with and without dementia[J].J Am Geriatr Soc,2011,59:2306-2313.
• [6]Lee KH,Ha YC,Lee YK,et al.Frequency,risk factors,and prognosis of prolonged delirium in elderly patients after hip fracture surgery[J].Clin Orthop,2011,469:2612-2620.
• [7]Lee HJ,Hwang DS,Wang SK,et al.Early assessment of delirium in elderly patients after hip surgery[J].Psychiatry Investig,2011,8:340-347.
• [8]Brown CA,Boling J,Manson M,et al.Relation between prefracture characteristics and perioperative complications in the elderly adult patient with hip fracture[J].South Med J,2012,105:306-310.
• [9]Moerman S,Tuinebreijer WE,de Boo M,et al.Validation of the risk model for delirium in hip fracture patients[J].Gen Hosp Psychiatry,2012,34:153-159.
• [10]Nie H,Zhao B,Zhang YQ,et al.Pain and cognitive dysfunction are the risk factors of delirium in elderly hip fracture Chinese patients[J].Arch Gerontol Geriatr,2012,54:172-174.
• [11]Vochteloo AJ,Borger van der Burg BL,Mertens B,et al.Outcome in hip fracture patients related to anemia at admission and allogeneic blood transfusion:an analysis of 1262 surgically treated patients[J].BMC Musculoskelet Disord,2011,12:262.
• [12]Radtke FM,Franck M,Lendner J,et al.Monitoring depth of anaesthesia in a randomized trial decreases the rate of postoperative delirium but not postoperative cognitive dysfunction[J].Br J Anaesth,2013,110:98-105.
• [13]Rashiq S,Vandermeer B,Abou-Setta AM,et al.Efficacy of supplemental peripheral nerve blockade for hip fracture surgery:multiple treatment comparison[J].Can J Anaesth,2013,60:230-243.
• [14]Akunne A,Davis S,Westby M,et al.The cost-effectiveness of multi-component interventions to prevent delirium in older people undergoing surgical repair of hip fracture[J].Eur J Orthop Surg Traumatol,2013.Epub abead of print.
• [15]Folbert EC,Smit RS,van der Velde D,et al.Geriatric fracture center:a multidisciplinary treatment approach for older patients with a hip fracture improved quality of clinical care and short-term treatment outcomes[J].Geriatr Orthop Surg Rehabil,2012,3:59-67.
• [16]Zapatero A,Barba R,Canora J,et al.Hip fracture in hospitalized medical patients[J].BMC Musculoskelet Disord,2013,14:15.
• [17]Vochteloo AJ,Moerman S,van der Burg BL,et al.Delirium risk screening and haloperidol prophylaxis program in hip fracture patients is a helpful tool in identifying high-risk patients,but does not reduce the incidence of delirium[J].BMC Geriatr,2011,11:39.