术中监测局部脑氧饱和度在老年直肠癌根治术患者POD中的预测价值  

The predictive value of intraoperative monitoring of regional cerebral oxygen saturation in POD in elderly patients undergoing radical resection of rectal cancer

作　　者：仇灵琴[1] 葛莉 周海娇 QIU Lingqin;GE Li;ZHOU Haijiao(Department of Anesthesiology,Gansu Provincial Hospital,Gansu,Lanzhou 730000,China)

机构地区：[1]甘肃省人民医院麻醉科,甘肃兰州730000

出　　处：《中国医药科学》2024年第6期84-87,共4页China Medicine And Pharmacy

基　　金：甘肃省自然科学基金支撑项目(22JR11RA260)。

摘　　要：目的探讨术中监测局部脑氧饱和度(rSO_(2))在老年直肠癌根治术患者术后谵妄(POD)中的预测价值。方法选取2022年8月至2023年2月在甘肃省人民医院麻醉科行直肠癌根治术的88例老年患者为研究对象,入室后监测麻醉诱导前(T_(0))、气管插管后(T_(1))、手术开始时(T_(2))、手术开始1 h(T_(3))、手术开始2 h(T_(4))和手术结束(T_(5))rSO_(2)、心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO_(2)),以T_(0)时rSO_(2)为基线值,计算rSO_(2)最小值(rSO_(2) min)、平均值(rSO_(2) mean)、与基线值下降的最大差值(rSO_(2)%max)。术后根据是否出现POD分为POD组和非POD组,比较两组HR、MAP、SpO_(2)及rSO_(2)。结果POD组和非POD组T_(0)、T_(1)、T_(2)、T_(3)、T_(4)和T_(5)时HR、MAP、SpO_(2)以及T_(0)、T_(1)、T_(2)时rSO_(2)指标比较,差异无统计学意义(P>0.05),POD组T_(3)、T_(4)和T_(5)时rSO_(2)低于非POD组,差异有统计学意义(P<0.05)。POD组与非POD组rSO_(2)基线值比较,差异无统计学意义(P>0.05),POD组rSO_(2) min和rSO_(2) mean低于非POD组,POD组rSO_(2)%max高于非POD组,差异有统计学意义(P<0.05)。结论rSO_(2)降低与老年直肠癌根治术患者POD相关,可将rSO_(2)作为预测POD的指标。Objective To explore the predictive value of intraoperative monitoring of regional cerebral oxygen saturation(rSO_(2))in postoperative delirium(POD)in elderly patients undergoing radical resection of rectal cancer.Methods A total of 88 patients who underwent radical resection of rectal cancer in the Department of Anesthesiology,Gansu Provincial Hospital from August 2022 to February 2023 were observed.rSO_(2),heart rate(HR),mean arterial pressure(MAP),and blood oxygen saturation(SpO_(2))before anesthesia induction(T_(0)),after tracheal intubation(T_(1)),at the beginning of surgery(T_(2)),at 1 h after the beginning of surgery(T_(3)),at 2 h after the beginning of surgery(T_(4)),and at the end of surgery(T_(5))were monitored after included.rSO_(2) at T_(0) was considered as the baseline value,to calculate the minimum value(rSO_(2)min),mean value(rSO_(2)mean),and maximum difference decreased from the baseline value(rSO_(2)%max)of rSO_(2).After surgery,patients were divided into a POD group and a non-POD group based on the presence or absence of POD.HR,MAP,SpO_(2),and rSO_(2) were compared between the two groups.Results The HR,MAP,and SpO_(2) at T_(0),T_(1),T_(2),T_(3),T_(4),and T_(5),and rSO_(2) at T_(0),T_(1) and T_(2) between the POD group and the non-POD group were compared,without statistically significant differences(P>0.05).The rSO_(2) at T_(3),T_(4),and T_(5) in the POD group were lower than those in the non-POD group,with statistically significant difference(P<0.05).The rSO_(2) baseline value was compared between the POD group and the non-POD group,without statistically significant difference(P>0.05).The rSO_(2) min and rSO_(2) mean in the POD group were lower than those in the non-POD group,while the rSO_(2)%max in the POD group was higher than that in the non-POD group,with statistically significant differences(P<0.05).Conclusion The decrease in rSO_(2) is associated with POD in elderly patients undergoing radical resection of rectal cancer,and rSO_(2) can be used as a predictor of POD.

关 键 词：局部脑氧饱和度 老年 直肠癌根治术 谵妄 

分 类 号：R614[医药卫生—麻醉学] R735.34[医药卫生—外科学]