TURP术后老年患者认知功能变化和术中局部脑氧饱和度相关性研究  

Correlation between Postoperative Cognitive Dysfunction and Intraoperative Regional Cerebral Oxygen Saturation in Elderly Patients after Transurethral Resection of Prostate

作　　者：胡远[1] 陈亮[1] 何文胜[1] HU Yuan;CHEN Liang;HE Wensheng(Second People’s Hospital in Hefei,Hefei 230011,China)

机构地区：[1]合肥市第二人民医院,安徽合肥230011

出　　处：《北华大学学报（自然科学版）》2020年第2期215-218,共4页Journal of Beihua University（Natural Science）

基　　金：安徽省科技攻关基金项目(131042197).

摘　　要：目的探讨经尿道前列腺电切术(TURP)老年患者术后认知功能变化和术中局部脑氧饱和度(rSO2)的关系.方法选择行TURP治疗的前列腺增生症患者95例,根据是否发生手术后认知功能障碍(POCD)将患者分为POCD组(38例)和非POCD组(57例),分别于术前1 d及术后1、3、5、7 d使用简易精神状态检查量表(MMSE)测试所有患者的认知功能,同时,分别于术前10 min(T0)、麻醉诱导平稳后(T1)、手术开始10 min(T2)、手术开始30 min(T3)、手术结束时(T4)监测rSO2水平变化.结果两组年龄、体质量指数(BMI)、教育年限、手术时间、术中出血量、前列腺切除质量等基线资料比较差异无统计学意义(P>0.05).术后1、3、5、7 d POCD组MMSE评分均明显低于非POCD组,差异具有统计学意义(P<0.05).T2、T3、T4时POCD组rSO2水平均明显低于非POCD组,差异具有统计学意义(P<0.05).相关分析结果显示:rSO2水平与MMSE评分呈明显正相关(P<0.05).结论TURP术中rSO2的降低与老年患者POCD的发生可能关系密切,rSO2实时监测可降低POCD的发生率.Objective To investigate the relationship between postoperative cognitive dysfunction and intraoperative regional cerebral oxygen saturation(rSO2) in elderly patients after transurethral resection of the prostate(TURP).Method 95 patients with benign prostatic hyperplasia treated with TURP were divided into POCD group(38 cases) and non-POCD group(57 cases) according to the occurrence of POCD.The cognitive function of all patients was tested by MMSE on the 1 st day before operation and the 1st,3rd,5th and 7th day after operation.At the same time,the levels of rSO2 were monitored at 10 minutes(T0) before operation,10 minutes after anesthesia induction(T1),10 minutes after operation(T2),30 minutes after operation(T3) and at the end of operation(T4).Results There were no significant differences in baseline data of age,body mass index,years of education,operation time,intraoperative bleeding volume and quality of prostatectomy between the two groups(P>0.05).MMSE scores in POCD group were significantly lower than those in non-POCD group at 1st day,3rd day,5th day and 7th day after operation(P < 0. 05). At T2,T3 and T4,rSO2 levels in POCD group were significantly lower than those in non-POCD group(P<0.05).The results of correlation analysis showed that rSO2 level was positively correlated with MMSE score(P < 0. 05). Conclusion The decrease of rSO2 during TURP may be closely related to the occurrence of POCD in elderly patients.Real-time monitoring rSO2 may reduce the incidence of POCD.

关 键 词：经尿道前列腺电切术 认知功能 局部脑氧饱和度 相关性 

分 类 号：R699[医药卫生—泌尿科学]