Japanese

Title	術後せん妄の発生状況とリスク因子の検討
Subtitle	研究報告
Authors	矢野由香*, 久我貴之*, 重田匡利*, 池下貴広*, 升井規晴*
Authors (kana)
Organization	*長門総合病院外科
Journal	日本農村医学会雑誌
Volume	74
Number	1
Page	19-24
Year/Month	2025 / 5
Article	報告
Publisher	日本農村医学会
Abstract	術後せん妄は手術後に見当識障害や妄想・幻覚などに関連した異常行動を呈する精神状態である. 術前にせん妄発症のリスクを評価し, 術後のせん妄症状とその対応について検討したので報告する. 対象は2022年11月〜2023年4月に全身麻酔手術を受けた患者71例. 評価にはDELTAプログラムせん妄アセスメントシートを用い, 入院時に準備因子を評価し1つでも該当すればハイリスクとしてせん妄症状のチェックを行なった. 全身麻酔は準備因子の1つであるため71例全例せん妄ハイリスクであった. 術後, 症状が1つでもあればせん妄対応とし促進因子を評価, 治療を行なった. 術後せん妄症状を有した症例は17例であった. 術後せん妄症状あり(Y群), なし(N群)に分け準備因子について検討した. Y群は70歳以上, 脳器質的障害あり, 認知症併存が有意に多かった. Y群の平均年齢は78.5歳, N群69.4歳と有意に高齢であった. 両群間で手術時間, 麻酔時間, 出血量, 輸血量などに有意差は認めなかった. Y群のせん妄症状は注意力の欠如15例, 思考の解体8例, 意識レベルの変容6例. 対応として抑制15例, 抗精神薬投与10例, 睡眠薬投与4例. モニターやカテーテルなどの早期除去と昼夜逆転を防ぐためのリハビリテーション早期導入を全例で行なった. 70歳以上, 脳器質的障害を有する手術患者では特に術後せん妄発症に留意すべきと考える. 準備因子を特定し, 術前にせん妄発症のリスクを評価することで早期介入が可能である.
Practice	臨床医学：一般
Keywords	術後せん妄, リスク因子, 早期介入

English

Title	Investigation of the Incidence and Risk Factors of Postoperative Delirium
Subtitle	RESEARCH REPORT
Authors	Yuka YANO*, Takayuki KUGA*, Masatoshi SHIGETA*, Takahiro IKESHITA*, Noriharu MASUI*
Authors (kana)
Organization	*Dept. of Surgery, Nagato General Hospital
Journal	Nihon Noson Igakkai Zassi
Volume	74
Number	1
Page	19-24
Year/Month	2025 / 5
Article	Report
Publisher	The Japanese Association of Rural Medicine
Abstract	Postoperative delirium is a neuropsychiatric disorder characterized by abnormal behaviors following surgery, including disorientation, delusions, and hallucinations. This study preoperatively assessed predisposing factors for delirium and examined its postoperative symptoms and treatments. A total of 71 patients who underwent general anesthesia were included. Delirium assessment sheets from the DELirium Team Approach (DELTA) program were used for delirium evaluation. Postoperative delirium was observed in 17 cases. Patients were divided into two groups: those with postoperative delirium symptoms (delirium group) and those without (non-delirium), and their predisposing factors were compared. The delirium group had a significantly higher proportion of patients aged 70 years or older, as well as patients with organic brain disorders and coexisting dementia. The mean age was significantly higher in the delirium group (78.5 years) compared to the non-delirium group (69.4 years). No significant differences were observed between the two groups in operative time, duration of anesthesia, blood loss, or transfusion volume. Delirium symptoms in the delirium group included inattention in 15 cases, disorganized thinking in 8 cases, and altered levels of consciousness in 6 cases. Treatments included physical restraints in 15 cases, administration of antipsychotic medications in 10 cases, and use of sedative-hypnotics in 4 cases. Particular attention should be given to the risk of postoperative delirium, especially in surgical patients aged 70 or older and those with organic brain disorders.
Practice	Clinical medicine
Keywords

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