食管癌根治术前病人轻度认知功能障碍的影响因素分析

    Analysis of the influencing factors of mild cognitive impairment in patients before esophageal cancer radical surgery

    • 摘要:
      目的 探究食管癌病人在食管癌根治术前的认知功能改变及其影响因素。
      方法 选取择期全麻下行食管癌切除术病人,收集病人基线资料及术前简易智力状态检查量表(MMSE)评分。依据术前的MMSE评分将病人分为轻度认知功能障碍(MCI)组和非MCI组。采用二元logistic回归分析影响食管癌病人认知功能改变的影响因素。
      结果 最终纳入183例食管癌病人,其中125例(68.31%)病人出现MCI。单因素二元logistic回归分析显示:年龄(OR=1.06, 95%CI: 1.02~1.10, P < 0.01)、教育程度(小学,OR=0.29, 95%CI: 0.12~0.71, P < 0.01;初中及以上,OR=0.30, 95%CI: 0.12~0.75, P=0.01)、饮酒史(OR=0.44, 95%CI: 0.23~0.84, P=0.01)是影响食管癌病人术前MCI的因素。多因素二元logistic回归分析显示,年龄(OR=1.05, 95%CI: 1.01~1.09, P=0.03)和教育程度(小学,OR=0.35, 95%CI: 0.14~0.88, P=0.03)为食管癌病人术前MCI的独立影响因素。
      结论 食管癌病人在食管癌根治术前出现MCI的概率较大,年龄和受教育程度是其术前MCI的独立影响因素。围术期医护团队可以根据危险因素制订针对性的治疗或预防对策,改善病人认知功能进而提升病人术后早期康复质量。

       

      Abstract:
      Objective  To explore the changes of cognitive function and its influencing factors in patients with esophageal cancer before radical resection of esophageal cancer.
      Methods  The patients scheduled for esophageal cancer resection under general anesthesia were selected.The baseline data and preoperative Mini-mental State Examination(MMSE) scores of patients were collected.The patients were divided into the mild cognitive impairment (MCI) group and non-MCI group according to the preoperative MMSE score.Binary logistic regression analysis was used to analyze the influencing factors of cognitive function changes in patients with esophageal cancer.
      Results  A total of 183 patients with esophageal cancer were ultimately included, among whom 125 cases(68.31%) developed MCI.The results of univariate binary logistic regression analysis showed that the age(OR=1.06, 95%CI: 1.02-1.10, P < 0.01), educational level(primary school, OR=0.29, 95%CI: 0.12-0.71, P < 0.01), junior high school education and above, OR=0.30, 95%CI: 0.12-0.75, P=0.01) and history of alcohol consumption(OR=0.44, 95%CI: 0.23-0.84, P=0.01) were the factors influencing preoperative MCI in patients with esophageal cancer.The results of multivariate binary logistic regression analysis showed that the age(OR=1.05, 95%CI: 1.01-1.09, P=0.03) and educational level(primary school, OR=0.35, 95%CI: 0.14-0.88, P=0.03) were the independent influencing factors of preoperative MCI in patients with esophageal cancer.
      Conclusions  Patients with esophageal cancer have a relatively high probability of developing MCI before radical resection of esophageal cancer.The age and educational level are the independent influencing factors of MCI before surgery.The perioperative medical team can formulate targeted treatment or preventive strategies based on risk factors to improve patients′ cognitive function, and thereby enhance the quality of early postoperative rehabilitation.

       

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