2020年 · 第100卷第36期

Rational application of antimicrobial drugs is the core of the treatment of bacterial infectious diseases. In recent years, the resistance rate of clinical isolates to commonly used antimicrobial drugs in China has been increasing continuously, and multi-drug resistant bacteria are becoming more and more common^[1]The difficulty of treatment increases, and the medical burden increases^[2]。 The long course of antimicrobial treatment is one of the main reasons leading to drug resistance, and the reasonable timing of drug withdrawal is still a huge clinical problem. The rapid development of experimental diagnosis technology provides more references for the rational application of antibacterial drugs.

Postoperative delirium is one of the most common postoperative complications in elderly patients, associated with postoperative neurocognitive impairment, prolonged hospital stay, and poor survival. But the relationship between postoperative delirium and long-term activities of daily living and mortality remains unclear. To clarify the effect of postoperative delirium on the long-term decline in activities of daily living and postoperative mortality, the study selected 130 patients over 65 years of age who underwent surgery for internal fixation of fractures under general anesthesia. Delirium was diagnosed by a fuzzy assessment algorithm before surgery and on the 1st, 2nd and 4th postoperative days, activities of daily living were assessed by the Chinese version of the Activities of Daily Living Scale (14 to 56 points), and preoperative cognitive function was assessed by the Brief Mental Status Examination Scale (0 to 30 points). Follow-up assessment was performed 24 to 36 months after surgery, including activities of daily living and mortality. The results showed that 34 (26%) of 130 patients developed delirium on the 1st, 2nd and 4th postoperative days after anesthesia and surgery. Patients with postoperative delirium were older and had more severe preoperative cognitive impairment than those without delirium. Patients with postoperative delirium had a greater decline in activities of daily living and a higher mortality rate at 36 months.