老年患者围手术期脑功能状态定量监测结果与术后认知功能障碍的相关性初探  

Preliminary discussion on the correlation between perioperative brain function state quantitative monitoring results and postoperative cognitive dysfunction in elderly patients

作　　者：刘晓华[1] 王燕[1] 李立新[1] Liu Xiaohua Wang Yan Li Lixin(Department of Anesthesiology, Yan＇ an People＇s Hospital, Shanxi Yan＇an, 716000, China)

机构地区：[1]陕西省延安市人民医院麻醉科,716000

出　　处：《中国医师进修杂志》2016年第11期1001-1004,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的：探讨老年患者围手术期脑功能状态定量监测结果与术后认知功能障碍（POCD）的相关性。方法选取200例腰椎减压融合手术患者，根据Z计分法分为POCD组（134例）和非POCD组（66例），对比两组脑功能状态定量监测结果，包括小波指数（WLI）、内专注指数（i_22）和脑活性指数（i_20）。结果围手术期老年患者不同时点脑功能指标特征分析结果显示，术后第7天WLI（96.24±2.41）明显高于术前1 d（98.76±2.65）和术后第3天（98.68±3.01），差异有统计学意义（t＝4.475、4.475，P＝0.000、0.000）。i_22在术前1 d、术后第3天、术后第7天比较差异无统计学意义（F＝7.365，P＝0.075）。i_20在术前1 d、术后第3天、术后第7天比较差异无统计学意义（F＝6.663，P＝0.068）。术前1 d POCD 组 i_22（241.57±6.54）低于非 POCD 组（265.33±8.32），差异有统计学意义（t＝15.875，P＝0.000）。结论围手术期老年患者不同时点脑功能状态定量监测结果有一定的特征，i_22可以考虑作为判断出现POCD的指标。Objective To discuss the correlation of perioperative brain function state quantitative monitoring results with postoperative cognitive dysfunction （POCD） in elderly patients. Methods The clinical data of 200 patients with lumbar spinal decompression fusion surgery were analyzed retrospectively. They were divided into the POCD group （134 patients） and the non POCD group （66 patients） by Z count scores . The results of test indexes including wavelet index （WLI）, concentration index （i_22） and brain activity index （i_20） were compared. Results Perioperative elderly patients Brain function characteristics analysis results of perioperative elderly patients showed that the level of WLI at postoperative day 7（96.24 ± 2.41）was higher than that at preoperative day 1（98.76 ± 2.65） and postoperative day 3（98.68 ± 3.01）, and there were significant differences （t=4.475, 4.475, P=0.000, 0.000）. The level of i_22 at preoperative day 1, postoperative day 3 and postoperative day 7 had no significant difference （F=7.365, P=0.075）. The level of i_20 at preoperative day 1, postoperative day 3 and postoperative day 7 had no significant difference （F=6.663, P=0.068）. At preoperative day 1, the level of i_22 in POCD group was significantly lower than that in non POCD group（t=15.875, P=0.000）. Conclusions Brain function index of perioperative elderly patients has certain characteristics in different time points, and i_22 may could be considered as a judge index of POCD.

关 键 词：术后认知功能障碍 脑功能状态定量 围手术期 

分 类 号：R614[医药卫生—麻醉学]