老年椎管内麻醉患者术中脑氧饱和度对早期术后认知功能障碍的影响  

Effects of intraoperative cerebral oxygen saturation on early postoperative cognitive dysfunction in elderly patients with intrathecal anesthesia

作　　者：陈志强 高满海[1] 蔡强[1] 魏巍[1] 杜翠玉 Chen Zhiqiang;Gao Manhai;Cai Qiang;Wei Wei;Du Cuiyu(Department of Surgical Anesthesia,First Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou,Inner Mongolia 014010,China;Department of Orthopedics,General Hospital of Tianjin Medical University,Tianjin 300052,China)

机构地区：[1]内蒙古科技大学包头医学院第一附属医院麻醉手术科,包头014010 [2]天津医科大学总医院骨科,天津300052

出　　处：《中华生物医学工程杂志》2021年第4期391-396,共6页Chinese Journal of Biomedical Engineering

摘　　要：目的探讨老年椎管内麻醉患者术中脑氧饱和度对早期术后认知功能障碍(POCD)的影响。方法选择2019年7-10月包头医学院第一附属医院60岁以上ASA Ⅰ~Ⅲ级椎管内麻醉下行择期手术的老年患者64例,随机分为脑氧饱和度(rSO_(2))干预组和非干预组,每组32例。干预组于术中采取如唤醒等干预措施,使rSO_(2)值维持在基础值的89%以上,绝对值在50以上;非干预组在术中仅监测脑氧饱和度而不予干预。于术后1和4 d采用ISPOCD推荐的复合Z分法评估患者术后认知功能障碍的发生。结果干预组术中rSO_(2)下降均未超过11%,非干预组有26例下降,其中10例下降超过11%(P<0.05)。术后1和4 d,干预组POCD发生率均低于非干预组(P<0.05)。结论围术期对rSO_(2)进行适时适度干预可以改善术后认知功能,降低术后早期认知功能障碍的发生率。Objective To investigate the effects of intraoperative cerebral oxygen saturation on early postoperative cognitive dysfunction in elderly patients with intrathecal anesthesia.Methods Select 64 elderly patients over 60 years of age undergoing elective surgery under ASAⅠ-Ⅲspinal anesthesia;64 patients were randomly divided into intervention group and non-intervention group according to whether or not to take intervention measures on intraoperative cerebral oxygen saturation(rSO_(2))Degree,32 cases in each group.In the intervention group,intervention measures such as arousal were taken during the operation to keep the rSO_(2) value above 89% of the basic value and the absolute value above 50;in the non-intervention group,only monitored cerebral oxygen saturation during the operation without intervention.On the 1st and 7th day after the operation,the composite Z-score recommended by ISPOCD was used to assess the occurrence of postoperative cognitive dysfunction in patients.Results In the intervention group,the cerebral oxygen saturation did not decrease by more than 11%,and in the non-intervention group,the cerebral oxygen saturation of 26 patients decreased,and 10 of them declined by more than 11%(P<0.05).At 1st and 7th days after operation,the incidence of POCD in the intervention group was lower than that in the non-intervention group(P<0.05).Conclusion Timely and moderate intervention of cerebral oxygen saturation during perioperative period can improve postoperative cognitive function and reduce the incidence of early postoperative cognitive dysfunction.

关 键 词：认知功能障碍 麻醉 脊椎 血氧测定法 

分 类 号：R614[医药卫生—麻醉学]