摘要
目的研究全麻肾癌根治术后认知功能与血尿酸、同型半胱氨酸水平的关系及其危险因素。方法选择2019年3月至2020年12月在我院接受肾癌根治术的患者115例,根据手术前后简易智能量表(MMSE)评分评价术后认知功能障碍(POCD),比较POCD组与非POCD组临床资料、实验室指标,并分析POCD的危险因素。结果发生POCD组32例。POCD组患者术前血尿酸水平明显低于非POCD组,血同型半胱氨酸水平明显高于非POCD组;POCD组患者的年龄、高同型半胱氨酸血症例数、低尿酸血症例数、合并糖尿病例数、合并高血压例数、合并颈动脉粥样斑块例数均明显高于非POCD组,差异有统计学意义(P<0.05);Logistics回归分析示高龄、高同型半胱氨酸血症、低尿酸血症及合并颈动脉粥样斑块是发生POCD的独立危险因素。结论高龄、高同型半胱氨酸血症、低尿酸血症及合并颈动脉粥样斑块是肾癌根治术后发生认知功能障碍的危险因素,需针对性地进行预防。
Objective To explore the relationship between cognitive function and levels of serum uric acid(UA)and homocysteine(Hcy)after radical nephrectomy under general anesthesia and analyzethe risk factors.Methods One hundred and fifteen patients who underwent radical nephrectomy in our hospital from March 2019 to December 2020were selected.Postoperative cognitive dysfunction(POCD)were evaluatedaccording to the changes of MMSE scores before and after operation.Then,the patients were divided into a POCD group and a non-POCD group.The differences of clinical data and laboratory indicators between the two groups were compared and the risk factors of POCD were analyzed.Results A total of 32 patients with POCD occurred.The preoperative UA level in the POCD group was significantly lower than that in the non-POCD group while Hcy level was significantly higher than that in the non-POCD group.Age in the POCD group was significantly older than that in the non-POCD group,and the number of cases of hyperHcy,hypoUA,diabetes,hypertension and carotid atherosclerosis were significantly higher in the POCD group than those in the non-POCD group(P<0.05).The logistics analysis showed that advanced age,hyperHcy,hypoUA,and carotid atherosclerosis were independent risk factors for POCD.Conclusion Advanced age,hyperHcy,hypoUA,and carotid atherosclerotic plaque are risk factors for cognitive dysfunction after radical nephrectomy for renal cell carcinoma.POCD needs to be prevented.
作者
李新帅
孟帆
LI Xin-shuai;MENG Fan(Department of Anesthesiology, Nanyang Central Hospital, Nanyang 473000, China)
出处
《实用医院临床杂志》
2022年第4期61-64,共4页
Practical Journal of Clinical Medicine
基金
河南省中医药科学研究转向课题(编号:2018ZY3053)。
关键词
肾癌根治术
术后认知功能障碍
尿酸
同型半胱氨酸
Radical nephrectomy
Postoperative cognitive dysfunction
Uric acid
Homocysteine
