老年病人机器人辅助泌尿外科手术后近远期认知功能发展轨迹  

Development trajectory of cognitive function in elderly patients undergoing robot-assisted laparoscopic urological surgery

作　　者：崔银[1] 张富俊 马正良[1] 顾小萍[1] CUI Yin;ZHANG Fujun;MA Zhengliang;GU Xiaoping(Department of Anesthesiology,Affiliated Drum Tower Hospital of Nanjing University Medical School,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院麻醉科,江苏省南京市210008

出　　处：《实用老年医学》2025年第3期282-285,289,共5页Practical Geriatrics

基　　金：国家重点研发计划课题(2018YFC2001901);南京大学中国医院改革发展研究院课题项目;南京鼓楼医院医学发展医疗救助基金会资助项目(NDYG2022054)。

摘　　要：目的探讨机器人辅助泌尿外科手术老年病人术后近远期认知功能的发展轨迹。方法收集年龄≥65岁行机器人辅助泌尿外科手术病人的基本资料,使用MMSE、认知状态电话访谈修订版(Telephone Interview for Cognitive Status-Modified,TICS-m)量表进行神经认知功能评估,明确该类手术病人术后近远期认知功能的发展轨迹。结果老年病人机器人辅助泌尿外科手术后1、3、6个月认知功能障碍的发生率分别为26.7%、19.9%、14.3%,严重认知功能障碍的发生率为6.2%、4.7%、4.4%。此外,术前认知功能障碍组和认知功能正常组手术后3个月的TICS-m评分分别为(33.47±3.81)分和(35.12±4.12)分,2组间差异具有统计学意义(P=0.009)。与术后1个月认知功能正常的人群相比,术后1个月认知障碍的病人术后3个月和6个月发生认知功能障碍的概率显著增加。结论机器人辅助泌尿外科手术老年病人术前认知功能障碍与术后3个月认知功能障碍相关,术后1个月发生认知障碍对术后远期认知功能障碍的发生具有预警作用。Objective To explore the development trajectory of cognitive function in the elderly patients undergoing robot-assisted laparoscopic urological surgery.Methods The clinical data of the patients aged≥65 years old receiving robot-assisted laparoscopic urological surgery were analyzed.The patients underwent the assessment of cognitive function by Mini-mental State Examination(MMSE)and Telephone Interview for Cognitive Status-Modified(TICS-m)scale.The development trajectory of postoperative short-term and long-term cognitive function was analyzed.Results The incidence rate of cognitive impairment in the elderly patients undergoing robot-assisted urological surgery 1,3,6 months after surgery was 26.7%,19.9%and 14.3%,and the incidence rate of severe cognitive impairment was 6.2%,4.7%and 4.4%.The TICS-m score in preoperative cognitive impairment group 3 months after surgery was 33.47±3.81,compared with 35.12±4.12 in normal preoperative cognitive function group(P=0.009).Compared with the patients with normal cognitive function 1 month after surgery,the patients with postoperative cognitive impairment 1 month after surgery presented with higher incidence rates of postoperative cognitive impairment 3,6 months affter surgery.Conclusions Preoperative cognitive impairment in the elderly patients receiving robot-assisted urological surgery is associated with postoperative cognitive impairment 3 months after surgery.The occurrence of cognitive impairment 1 month after surgery has a warning effect on the occurrence of long-term cognitive impairment after surgery.

关 键 词：术后认知功能障碍 机器人辅助泌尿外科手术 老年人 术前认知功能 

分 类 号：R619[医药卫生—外科学]