老年心脏手术患者术中脑氧饱和度变化与术后认知功能障碍的关系研究

Study on the Relationship between Intraoperative Cerebral Oxygen Saturation Changes and Postoperative Cognitive Dysfunction in Elderly Patients Undergoing Cardiac Surgery

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DOI
刊名
Journal of International Psychiatry
年,卷(期) 2022, 49(4)
作者
作者单位

河南省安阳市人民医院心脏大血管外科 ;

摘要
摘要目的:探讨老年心脏手术患者术中脑氧饱和度(rSO2)变化与术后认知功能障碍的关系研究。方法:选择2018年6月-2021年1月100例老年体外循环心脏手术患者,术中监测局部rSO2,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rSO2基线值、最低值(rSO2min)、rSO2变化率以及围术期一般资料,采用单因素及多因素logistic回归分析调查术中rSO2变化、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rSO2min、rSO2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、rSO2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,rSO2min<57%、rSO2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rSO2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。
Abstract
[Abstract] Objective To explore the relationship between intraoperative cerebral oxygen saturation (rSO2) changes 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 rSO2 was monitored during the operation, and cognitive dysfunction screening was performed 1 week after surgery. The baseline value of rSO2, the lowest value (rSO2min), the rate of change of rSO2, 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 rSO2, perioperative data and postoperative cognitive dysfunction. Results Forty-four cases of cognitive dysfunction occurred in 100 elderly patients undergoing cardiac surgery, with an incidence rate of 44.00%. Univariate analysis showed that there were statistically significant differences in the rate of change of rSO2min, rSO2 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, rSO2 baseline value, and type of surgery between the two groups (P>0.05). Multivariate logistic regression analysis showed that rSO2min<57%, rSO2 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 rSO2 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
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
KeyWord
Key words Elderly Cardiac Surgery; Intraoperative Cerebral Oxygen Saturation; Postoperative Cognitive Dysfunction; Cardiopulmonary Bypass Time; Age
基金项目
页码 653-655
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杨书强*. 老年心脏手术患者术中脑氧饱和度变化与术后认知功能障碍的关系研究 [J]. 国际精神病学杂志. 2022; 49; (4). 653 - 655.

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