胸科手术中脑血氧含量下降与术后认知功能障碍的相关性分析  

Correlation Analysis of Reduced Cerebral Absolute Oximetry During Thoracic Surgery and Postoperative Cognitive Dysfunction

作　　者：张跃军[1] 李航[1] 

机构地区：[1]温州医科大学附属东阳医院麻醉科,322100

出　　处：《医学研究杂志》2015年第6期60-62,共3页Journal of Medical Research

基　　金：浙江省医药卫生科技计划项目(2011KYB152)

摘　　要：目的分析胸科手术单肺通气时的绝对脑血氧饱和度(absolute oximetry,Sct O2)下降程度与术后认知功能障碍是否存在相关性。方法研究对象为76例经历单侧肺通气胸科手术的患者,且通气时间>45min。记录指标包括Sct O2值和常规临床指标。简易精神状态测验(Mini-Mental State Exam,MMSE)用于评测术后3h和24h认知状态。Sct O2下降程度和术后认知功能障碍的相关性使用Spearman相关分析。结果单肺通气时,其中40例Sct O2<65%,15例Sct O2<60%,5例Sct O2<55%。术后3h,29%的患者存在MMSE评分下降超过2分,术后24h,10%的患者存在MMSE评分下降超过2分。术后认知功能障碍与Sct O2<65%的相关系数r2=0.272,Sct O2<60%的相关系数r2=0.285,以及Sct O2<55%的相关系数r2=0.297,都呈现明显的相关性。结论胸科手术单肺通气时Sct O2下降程度与术后认知功能障碍发生呈正相关。Objective To determine the relationship between postoperative cognitive dysfunction and decreased absolute oximetry （SctO2 ） during thoracic surgery. Methods A total of 76 patients received single - lung ventilation thoracic surgery with surgery time 〉 45min were enrolled. Monitoring parameters included SctO2 and general clinical statues. The Mini - Mental State Exam （MMSE） test was used to assess the cognitive function before operation and at 3 and 24 h after operation. The relationship between SctO2 and cognitive func- tion was analyzed by Spearman correlation test. Data were presented as interquartile range, and P 〈 0.05 represented statistical signifi- cance. Results SctO2 during SLV decreased exceed 65% , 60% and 55% in 40, 15 and 5 patients. 3h after surgery, there were 29% patients who had a decrease of MMSE exceed 2 points. 24h after surgery, there were 10% patients who had a decrease of MMSE exceed 2 points. Correlation coefficient of postoperative cognitive dysfunction and SetO2 〈 65% , 〈 60% , 〈 55% were 0. 272, 0. 285, 0. 297, all obviously. Conclusion Intraoperative decline of SctO2 during SLV thoracic surgery is positively related to postoperative cognitive dys- function.

关 键 词：术后认知功能障碍 单肺通气 胸科手术 

分 类 号：R749.1[医药卫生—神经病学与精神病学]