摘要
目的探讨单肺通气手术患者术后认知功能障碍与局部脑氧饱和度(rSO2)及血清β-淀粉样蛋白(β-AP)含量的关系。方法选取行单肺通气的胸科手术患者52例,分别于术前1 d和术后第7天行神经心理测验;术中持续监测rSO2,于麻醉诱导前(t1)、单肺通气开始(t2)、单肺通气结束(t3)、术毕24 h(t4)分别抽取颈内静脉血,测定血清β-AP含量。术后有15例患者发生认知功能障碍作为观察组,37例未发生认知功能障碍者作为对照组。对比2组患者神经心理测验结果以及不同时点的血清β-AP含量和rSO2、术中rSO2平均值、最小值、较基础值下降最大百分数。结果 t2时2组rSO2均明显高于t1时(P<0.05),观察组rSO2较基础值下降最大百分数明显高于对照组(P<0.05);观察组t4时血清β-AP含量明显高于t1时和对照组(P均<0.01);观察组术后第7天MMSE、数字符号和数字广度(顺背)测试得分均明显低于术前(P均<0.05);MMSE及词汇流畅性测验评分明显低于对照组(P均<0.05)。结论单肺通气术后认知功能障碍可能与rSO2下降及血清β-AP含量升高有关。
Objective It is to study the relationship of postoperative cognitive dysfunction of single-lung ventilation with regional cerebral oxygen saturation（ rSO2） and serumβ-amyloid protein（ β-AP） content. Methods 52 patients received thoracic surgery with single lung ventilation and 20 cases of healthy people with no significant difference in the gender,age,culture level were selected. Neuropsychological test were performed at one day before operation and on the seventh day after operation. rSO2 were continuously detected during the operation. Internal jugular venous blood was extracted to respectively measure the serum β- AP content before anesthesia induction（ t1）,single lung ventilation start（ t2）,single lung ventilation end（ t3）,operation finish 24 h（ t4）.15 cases with postoperative cognitive dysfunction were chosen as observation group,37 cases without cognitive impairment as control group. The neuropsychological test results and serum β- AP content at different time and rSO2 such as average value,minium value and the biggest down percentage compared with basic value were compared between the patients in both groups. Results The rSO2 at t2of the two groups were significantly higher than that at t1（ P〈0.05）.The biggest down percentage compared with basic values of rSO2 of the observation group were significantly higher than that of control group（ P〈0. 05）. The serum β- AP content of the observation group at t4 was significantly higher than that at t1 and the control group（ P〈0. 01）. The MMSE,Numbers symbols and digit span（ in sequence） scores of the observation group on postoperative seventh day were significantly lower than that before operation（ P〈0. 05）. The MMSE and word fluency test score were significantly lower than that of the control group（ P〈0. 05）. Conclusion Postoperative cognitive dysfunction of single-lung ventilation may be related to the declination of rSO2 and elevation of serumβ- AP content.
出处
《现代中西医结合杂志》
CAS
2014年第26期2864-2867,共4页
Modern Journal of Integrated Traditional Chinese and Western Medicine
关键词
单肺通气
术后认知功能障碍
局部脑氧饱和度
Β-淀粉样蛋白
single lung ventilation
postoperative cognitive dysfunction
regional cerebral oxygen saturation
β-amyloid protein
