老年心脏手术患者术中的脑氧饱和度与术后认知功能障碍的关系  

The relationship between intraoperative cerebral oxygen saturation and postoperative cognitive dysfunction in elderly patients undergoing cardiac surgery

作　　者：杨书强[1] 王俊生[1] 高源 李苗苗 YANG Shuqiang;WANG Junsheng;GAO Yuan(Anyang People’s Hospital,Anyang 455000,China)

机构地区：[1]安阳市人民医院,安阳455000

出　　处：《国际精神病学杂志》2022年第4期653-655,668,共4页Journal Of International Psychiatry

摘　　要：目的探讨老年心脏手术患者术中脑氧饱和度(rSO_(2))与术后认知功能障碍的关系。方法选择2018年6月~2021年1月100例老年心脏手术患者,术中监测局部rSO_(2),术后1周进行认知功能障碍筛查,并设为认知功能障碍组与非认知功能障碍组,比较两组患者rSO_(2)基线值、最低值(rSO_(2min))、rSO_(2)变化率以及围术期资料,采用单因素及多因素Logistic回归分析调查术中rSO_(2)、围术期资料与术后认知功能障碍的关系。结果100例老年心脏手术患者术后发生认知功能障碍44例,发生率44.00%;单因素分析显示,认知功能障碍组与非认知功能障碍组在rSO_(2min)、rSO_(2)变化率、体外循环时间、年龄、术后心房颤动、术前心功能分级差异具有统计学意义(P<0.05);两组性别、rSO_(2)基线值、手术类型差异无统计学意义(P>0.05);多因素Logistic回归分析显示,rSO_(2min)<57%、rSO_(2)变化率>30%、体外循环时间>40min、年龄>70岁是老年心脏手术患者术后认知功能障碍的危险因素。结论老年心脏手术患者术中rSO_(2)过低、变化率大是术后认知功能障碍的危险因素,且认知功能障碍同时与体外循环时间、年龄等因素有关。Objective To explore the relationship between intraoperative cerebral oxygen saturation(rSO_(2))and postoperative cognitive dysfunction in elderly patients undergoing cardiac surgery.Methods A total of 100 elderly patients undergoing cardiopulmonary bypass surgery from June 2018 to January 2021 were selected.Local rSO_(2) was monitored during the operation,and cognitive dysfunction screening was performed 1 week after surgery.The baseline value of rSO_(2),the lowest value(rSO_(2min)),the rate of change of rSO_(2),and general perioperative data between the two groups of patients were compared.Univariate and multivariate logistic regression analysis were used to investigate the relationship between intraoperative changes of rSO_(2),perioperative data and postoperative cognitive dysfunction.Results Forty-four cases occurred cognitive dysfunction,with an incidence rate of 44.00%.Univariate analysis showed that there were statistically significant differences in the rate of change of rSO_(2min),r SO_(2) change rate,cardiopulmonary bypass time,age,postoperative atrial fibrillation,and preoperative cardiac function classification between the cognitive dysfunction group and the non-cognitive dysfunction group(P<0.05).There was no significant difference in gender,rSO_(2) baseline value,and type of surgery between the two groups(P>0.05).Multivariate logistic regression analysis showed that rSO_(2min)<57%,rSO_(2) change rate>30%,cardiopulmonary bypass time>40min,age>70 years old are risk factors for postoperative cognitive dysfunction in elderly patients undergoing cardiac surgery.Conclusion The low content of rSO_(2) and large change rate in elderly patients undergoing cardiac surgery are risk factors for postoperative cognitive dysfunction,and cognitive dysfunction is also related to factors such as cardiopulmonary bypass time and age.

关 键 词：老年心脏手术 术中脑氧饱和度 术后认知功能障碍 体外循环时间 年龄 

分 类 号：R749.23[医药卫生—神经病学与精神病学]