麻醉深度监测仪用于老年癌症患者术后认知功能损伤预测评估的价值研究  

The value of NT sedative depth monitor in predicting and assessing postoperative cognitive impairment of elderly patients with cancer

作　　者：王秀[1] 于化梅[1] 王瑞枝[2] 孙俊枝[2] WANG Xiu;YU Hua-mei;WANG Rui-zhi(Surgery Room,The Affiliated Hospital of Inner Mongolia Medical University,Hohhoto 10050,China;不详)

机构地区：[1]内蒙古医科大学附属医院手术室,内蒙古呼和浩特010000 [2]内蒙古医科大学附属医院麻醉科,内蒙古呼和浩特010000

出　　处：《中国医学装备》2021年第4期115-118,共4页China Medical Equipment

摘　　要：目的:探讨老年择期癌症手术中应用脑电分析的Narcotrend(NT)麻醉深度监测仪对预测术后患者认知功能损伤的价值。方法:选取在医院择期行全麻手术的118例老年癌症患者,术中全部给予NT麻醉深度监测仪行麻醉深度监测,记录术中、术后各时间点深麻醉Narcotrend指数(NTI),同时通过近红外无创脑部血氧饱和度监护仪评估脑组织缺血缺氧程度。所有患者于术后24 h进行认知功能简易精神状态检查(MMSE)量表评分,按MMSE评分将术后患者分为认知功能损伤组(37例)和认知功能正常组(81例),比较两组深麻醉和脑组织缺血缺氧情况。结果:经MMSE量表测量,120例患者术后诊断为认知功能损伤37例(占30.83%),认知功能正常组患者术后1 h(T_(2))、术后2h(T_(3))时NTI值、局部脑氧饱和度(rSO_(2))水平高于认知功能损伤组,差异有统计学意义(t=2.754,t=3.205,t=2.239,t=2.158;P<0.05),其余各时间点差异无统计学意义;认知功能损伤组与认知功能正常组比较,术中NTI值<35,ΔrSO_(2)>13%和rSO_(2)<55%的时间显著增加(t=5.641,t=3.360,t=2.799;P<0.05)。结论:NTI值预测认知功能损伤有较高价值,围术期采用NT麻醉深度监测仪对老年癌症患者进行麻醉深度的持续监测,有利于对麻醉实施精准调控。Objective:To investigate the value of Narcotrend(NT)sedation depth monitor with electroencephalogram(EEG)analysis in predicting postoperative cognitive impairment of elderly patients undergoing elective cancer surgery.Methods:118 elderly patients with cancer who underwent elective anesthesia in hospital were selected,and all of them underwent the monitoring of anesthesia depth by using NT sedation depth monitor during the operation.And Narcotrend index(NTI)of deep anesthesia index intraoperative and postoperative each time point were recorded.And the degrees of cerebral ischemia and hypoxia were assessed by monitor of near-infrared non-invasive cerebral blood oxygen saturation.All patients were scored by the mini-mental state examination(MMSE)at 24 th h after surgery.According to the MMSE score,the patients were divided into the cognitive impairment group(37 cases)and the normal cognitive function group(81 cases),and then the conditions of deep anesthesia and cerebral ischemia and hypoxia between two groups were compared.Results:As the measurement of MMSE scale,37 cases(30.83%)of the 120 patients were diagnosed as cognitive impairment after surgery.NTI value and regional cerebral oxygen saturation(rSO_(2))level at 1 th h(T_(2))and 2 th h(T_(3))after surgery in the normal group were significantly higher than those in the cognitive impairment group(t=2.754,t=3.205,t=2.239,t=2.158,P<0.05).and there was no statistical significance at other time points.Compared with the normal group,the times of intraoperative NTI value<35,ΔrSO_(2)>13%and rSO_(2)<55%were significantly increased in the cognitive impairment group(t=5.641,t=3.360,t=2.799,P<0.05).Conclusion:NTI value has a higher value in predicting cognitive impairment.The NT sedation depth monitor is used to continuously monitor the anesthesia depth of elderly patients with cancer during perioperative period,which is conducive to implement precise regulation of anesthesia.

关 键 词：Narcotrend麻醉深度监测仪 老年癌症 麻醉深度 认知功能损伤 

分 类 号：R473.59[医药卫生—护理学]