基于连续局部脑氧饱和度水平的目标导向管理对全麻下脊柱矫形手术术后谵妄的影响  

Effect of Goal-Oriented Management Based on Continuous Regional Cerebral Oxygen Saturation on Patients'Postoperative Delirium After Spinal Orthopedic Under General Anesthesia

作　　者：安晨 蒋腾 梁健[1] AN Chen;JIANG Teng;LIANG Jian(Department of Anesthesiology,Xuzhou Central Hospital,Xuzhou,Jiangsu,China 221009)

机构地区：[1]江苏省徐州市中心医院麻醉科,江苏徐州221009

出　　处：《中国药业》2022年第S02期92-94,共3页China Pharmaceuticals

摘　　要：目的探讨基于连续局部脑氧饱和度(rScO_(2))水平的目标导向管理对全身麻醉(简称全麻)下脊柱矫形术后谵妄的影响。方法选取医院2019年10月至2021年10月收治的脊柱侧弯患者97例,随机分为对照组(51例)和观察组(46例),两组患者均予常规全麻,对照组患者予常规麻醉监测,观察组患者予基于连续rScO_(2)水平的目标导向管理监测。结果观察组与对照组患者气管拔管即刻(T_(1)),气管拔管后1min(T_(2))、5min(T_(3))、10min(T_(4))时的心率、平均动脉压、血氧饱和度差异显著(F=8.154,P=0.000;F=7.654,P=0.000;F=1.154,P=0.687)。观察组术后自主呼吸恢复时间、睁眼时间、谵妄发生率均显著少于对照组,且发生谵妄患者的血清乙酰胆碱酯酶活性、丁酰胆碱酯酶活性均显著弱于未发生谵妄患者(P<0.05);脑源性神经营养因子水平显著高于非谵妄患者(P<0.05)。结论基于rScO_(2)水平的目标导向管理有助于减少全麻下脊柱矫形手术术后谵妄的发生,减轻患者脑神经功能损伤。Objective To investigate the effect of goal-oriented management based on continuous regional cerebral oxygen saturation(rScO_(2))level on patients'postoperative delirium after spinal orthopedic surgery under general anesthesia.Methods A total of 97 patients with scoliosis admitted to the hospital from October 2019 to October 2021 were selected and randomly divided into the control group(51 cases)and the observation group(46 cases).The patients in both groups were given routine general anesthesia.The patients in the control group were given routine anesthesia monitoring,while the patients in the observation group were given goal-oriented management monitoring based on continuous rScO_(2) levels.Results The levels of heart rate,mean arterial pressure and oxygen saturation of blood at T_(1),T_(2),T_(3) and T_(4) in the observation group were significantly different from those in the control group(F=8.154,P=0.000;F=7.654,P=0.000;F=1.154,P=0.687).The recovery time of spontaneous respiration,eye opening time and incidence of delirium in the observation group were significantly shorter than those in the control group,and the activities of serum acetylcholinesterase and butyrylcholinesterase in patients with delirium were significantly lower than those in patients without delirium(P<0.05).The level of brain-derived neurotrophic factor in patients with delirium were significantly higher than those in patients without delirium(P<0.05).Conclusion The goal-oriented management based on the of rScO_(2) level is helpful to reduce the occurrence of delirium after spinal orthopedic surgery under general anesthesia,and reduce the damage of brain nerve function of patients.

关 键 词：连续局部脑氧饱和度 目标导向管理 脊柱矫形手术 术后谵妄 

分 类 号：R969.4[医药卫生—药理学] R971.8[医药卫生—药学]