Clinical Observation Of Postoperative Delirium Cognitive Impairment And Subcomponent Analysis

Objective:Objective to clarify the cognitive function and the damage of each sub component in patients with postoperative delirium,and to determine the main manifestations of postoperative delirium.Methods:The elderly patients with normal preoperative cognitive function score were evaluated by CAM scale on the first day after operation.The patients with delirium were included in the experimental group(delirium group),and the patients without delirium were included in the control group(non-delirium group).At the same time,DST scale was used to evaluate the short-term memory of the two groups,and MMSE sub scale was used to evaluate the long-term memory,attention,orientation and language ability of the two groups.The scores of cognitive function of the two groups were recorded,and the incidence and severity of cognitive impairment were counted.The CAM scale was used to screen delirium on the second and third day after operation,and the total incidence of delirium was counted.Results:A total of 200 elderly patients undergoing general anesthesia were screened out.After 36 patients were excluded,43 patients with delirium were included in the experimental group(delirium group),and 121 patients without delirium were included in the control group(non-delirium group).The results showed that there were no significant differences in gender,education years,mortality and total length of stay between the two groups(P > 0.05),but there were significant differences in age,type of operation,blood transfusion during operation and ICU stay after operation(P < 0.05).There were significant differences in the scores of attention,short-term memory,long-term memory,orientation and language ability between the two groups after operation(P < 0.05),indicating that the two groups had impairment in all cognitive fields after operation.In delirium group,the incidence of attention impairment was 81.4%,short-term memory impairment was 76.7%,long-term memory impairment was 48.8%,orientation impairment was 44.2%,and language impairment was 46.5%.There were significant differences in the incidence of cognitive impairment(P < 0.05),and attention and working memory impairment was the most significant.Conclusion:When delirium occurs,all cognitive functions are impaired,among which attention impairment is the most significant.Attention and working memory impairment may be the main manifestation of delirium.