关键词: 肾癌, 全身麻醉, 根治性肾切除术, 高活动型谵妄

Abstract: Objective To explore risk factors of high activity delirium after laparoscopic radical nephrectomy combined with inferior vena cava tumor removal under general anesthesia in elderly patients with renal cell carcinoma.Methods 115 elderly patients with renal cell carcinoma who were underwent laparoscopic radical nephrectomy combined with inferior vena cava tumor thrombectomy were divided into N group (86 cases) and PHTD group(29 cases) from January 2019 to January 2021.They.Statistic and analyze the clinical data,operation and anesthesia conditions and postoperative conditions of patients in each group.Results The multiple factors Logistic regression analysis showed that age,ASA grade,anesthesia time,anesthetic dosage,extubation time,PACU residence time,sleep interference,intraoperative hypotension,postoperative pethidine dosage and postoperative body temperature were independent risk factors for the occurrence of highly-active delirium in elderly patients with cell carcinoma (P<0.05).The Nomogram analysis prediction model shows that the higher total risk of each factor,the high risk of delirium in elderly patients with cell carcinoma after kidney cancer surgery.The receiver operating characteristic（ROC）curve analysis showed performed,and the results showed that the area under the curve (AUC) of the prediction performance of the nomogram prediction model was 0.911（95%CI：0.847-0.975）（P<0.01）.Conclusion Age,ASA grade,anesthesia time,anesthetic dosage,extubation time,PACU residence time,sleep interference,intraoperative hypotension,postoperative pethidine dosage and postoperative body temperature are all independent risk factors for the occurrence of high-activity delirium during the recovery period after renal cancer surgery.

Key words: renal cell carcinoma, general anesthesia, laparoscopic radical nephrectomy, postoperative hyperactive-type delirium