Incidence and Risk Factors of Postoperative Delirium following Pancreatic Surgery: Does the Administration of TJ-54 Reduce the Incidence of Delirium?
Incidence and Risk Factors of Postoperative Delirium following Pancreatic Surgery: Does the Administration of TJ-54 Reduce the Incidence of Delirium?
复制标题
胰腺手术后谵妄的发生率和危险因素：TJ-54 的给药是否会降低谵妄的发生率？
DOI：
10.1159/000456627
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发表时间：
2017
期刊：
影响因子：
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通讯作者：
Isaji S.
中科院分区：
文献类型：
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作者：
Mizuno S;Takeuchi S;Kishiwada M;Mizutani N;Matsuda M;Sekoguchi N;Iizawa Y;Azumi Y;Kuriyama N;Usui M;Sakurai H;Maruyama K;Okuda M;Okada M;Isaji S.
目的：了解胰腺手术患者术后谵妄的发生率及危险因素，并探讨yokukansan （TJ-54）对减少谵妄的影响。方法：将59例连续行胰腺手术的患者（2012.4 ~ 2013.5）分为两组：TJ-54组：因失眠而接受TJ-54治疗的患者（n= 21）， No-TJ-54组：未接受TJ-54治疗的患者（n= 38），回顾性分析包括谵妄评定量表-日文版（DRS-J）在内的病历。结果：TJ-54组术后出现谵妄2例（9.5%），No-TJ-54组术后出现谵妄4例（10.5%）（p= 0.90）。术后5天，TJ-54组的DRS-J低于No-TJ-54组（p= 0.006），但经Bonferroni校正后无统计学差异。TJ-54组与no -TJ-54组住院费用差异无统计学意义（p= 0.78）。谵妄史被认为是术后谵妄的独立危险因素。结论：术前失眠症患者经TJ-54治疗后，术后谵妄发生率不高于术前无失眠症患者。有谵妄病史的患者术后谵妄的风险增加，应予以预防性护理和治疗以预防谵妄的发生。
Purposes:To clarify the incidence and risk factors of postoperative delirium in patients following pancreatic surgery, and the impact of yokukansan (TJ-54) administered to reduce delirium.Methods:Fifty-nine consecutive patients who underwent pancreatic surgery (2012.4-2013.5) were divided into 2 groups: TJ-54 group: patients who received TJ-54 (n= 21) due to insomnia and the No-TJ-54 group: patients who did not receive TJ-54 (n= 38), and the medical records including the delirium rating scale - Japanese version (DRS-J) were retrospectively reviewed.Results:Postoperative delirium occurred in 2 patients (9.5%) in the TJ-54 group and in 4 (10.5%) patients in the No-TJ-54 group (p= 0.90). The DRS-J on 5 days after surgery was lower in the TJ-54 group than in the No-TJ-54 group (roughp= 0.006), however, without any statistically significant differences with the Bonferroni correction. As for the hospital cost, there was no difference between the TJ-54 and the No-TJ-54 groups (p= 0.78). History of delirium was identified as an independent risk factor of postoperative delirium.Conclusion:The patients with preoperative insomnia, who were treated with TJ-54, did not have a higher incidence of postoperative delirium, compared to those without preoperative insomnia. The patients who had a history of delirium have an increased risk of postoperative delirium and should be cared for and treated prophylactically to prevent it.