【摘要】 目的 分析腹腔镜下子宫切除术患者麻醉苏醒期谵妄发生现状，探讨其影响因素，为临床预防和干预提供依据，提高术后康复质量。方法 选取2021年1月—2024年1月于张家口市第一医院择期行腹腔镜下子宫切除术的120例女性患者，收集患者围手术期相关数据，根据术后麻醉苏醒期是否发生谵妄分为谵妄组和非谵妄组。观察腹腔镜下子宫切除术患者麻醉苏醒期谵妄发生率。采用单因素和多因素logistic回归分析腹腔镜下子宫切除术患者麻醉苏醒期谵妄发生的独立危险因素。结果 子宫切除术患者谵妄发生率为13.34%（16/120）;单因素和多因素logistic回归分析结果显示，睡眠障碍、术前/中使用右美托咪定、CO₂气腹时间、手术时间、术中出血量、VAS评分及麻醉药物总量均是影响患者发生谵妄的因素（P分别为0.006、0.033、0.004、0.002、0.010、0.024及0.005,OR 95%CI分别为1.501～11.659、1.074～5.191、1.287～3.826、1.250～2.705、1.310～7.211、1.109～4.189及1.349～5.360）。结论 睡眠障碍、术前/中使用右美托咪定、CO₂气腹时间、手术时间、术中出血量、VAS评分及麻醉药物总量均是腹腔镜下子宫切除术患者麻醉苏醒期谵妄发生的影响因素，临床应针对以上影响因素积极预防干预。更多还原

【Abstract】 Objective To analyze the current status of delirium during anesthesia recovery in patients undergoing laparoscopic hysterectomy, to investigate its influencing factors, in order to provide evidence for clinical prevention and intervention and improve the quality of postoperative rehabilitation. Methods A total of 120 female patients who underwent elective laparoscopic hysterectomy in Zhangjiakou First Hospital from January 2021 to January 2024 were selected. Perioperative patient-related data were collected and divided into delirium group and non-delirium group according to whether delirium occurred during the postoperative anesthesia recovery period. The incidence of delirium during recovery from anesthesia in patients undergoing laparoscopic hysterectomy was observed. Univariate and multivariate logistic regression were used to analyze the independent risk factors for delirium during anesthesia recovery in patients undergoing laparoscopic hysterectomy. Results The incidence rate of delirium was 13.34%（16/120）. Univariate and multivariate logistic regression analysis results showed that sleep disorder, use of dexmedetomidine before/during surgery, CO₂ pneumoperitoneum time, operation time, intraoperative blood loss, VAS score and the total amount of anesthetic drugs were factors that affect the occurrence of delirium in patients（P=0.006, 0.033, 0.004, 0.002, 0.010, 0.024 and 0.005; OR 95% CI: 1.501-11.659, 1.074-5.191, 1.287-3.826, 1.250-2.705, 1.310-7.211, 1.109-4.189, and 1.349-5.360）. Conclusion Sleep disorder, preoperative/during use of dexmedetomidine, CO₂ pneumoperitoneum time, operation time, intraoperative blood loss, VAS score and total amount of anesthetic drugs are all factors that contribute to the occurrence of delirium during anesthesia recovery in patients undergoing laparoscopic hysterectomy. Clinical prevention and intervention should be actively targeted at the above risk factors.更多还原