摘要
目的:探讨体感诱发电位监测在高龄老年患者麻醉管理中的临床应用。方法:回顾性分析到医院就诊的需进行外科手术患者100例,按照年龄的不同将其分为高龄组(n=50)和非高龄组(n=50),再按照监测方式的不同将其分为高龄研究组(n=28)、高龄常规组(n=22)、非高龄研究组(n=26)和非高龄常规组(n=24),高龄研究组和非高龄研究组患者采用体感诱发电位监测评估,高龄常规组和非高龄常规组采用普通麻醉循环监测系统及经验法进行评估,比较手术中和手术后1 d四组患者的心肌标志物、炎症标志物以及脑钠肽(BNP)的水平变化,比较四组患者术后7 d肾功能,随访6个月,比较四组患者的不良事件(癫痫、脑梗、脊髓运动障碍、心肌梗死、认知功能障碍、再次血运重建)的发生率。结果:手术中,高龄研究组患者的Tn和CK-MB均显著低于高龄常规组(P<0.05)。手术后1 d,高龄研究组患者的Tn显著低于高龄常规组,且显著高于非高龄研究组和非高龄常规组(P<0.05),非高龄研究组患者的Tn均显著低于非高龄常规组(P<0.05),高龄研究组患者的CK-MB显著低于高龄常规组(P<0.05),高龄常规组患者的hs-CRP和BNP均显著高于高龄研究组(P<0.05),高龄常规组患者的hs-CRP和BNP均显著高于非高龄常规组(P<0.05),高龄常规组患者的Scr、EGFR、CYSC和MAU均显著高于高龄研究组(P<0.05),四组患者的不良事件发生率整体差异均无统计学意义(P>0.05)。结论:相较于非高龄患者,体感诱发电位监测可更有效地降低对高龄患者在麻醉过程中的心功能和肾功能损伤,并减少术后不良事件的发生风险,有助于提高麻醉管理质量。
Objective:To explore the clinical application of somatosensory evoked potential monitoring in anesthesia management of elderly patients.Methods:A retrospective analysis was used to classify 100 patients requiring surgical procedures in Hospital into senior(n=50)and non-senior(n=50)groups according to their age,and then into senior study(n=28),senior conventional(n=22),non-senior study(n=26)and non-senior conventional(n=24)groups according to their monitoring method.The elderly study group and non-elderly study group were evaluated by somatosensory evoked potential monitoring,and the elderly conventional group and non-elderly conventional group were evaluated by general anesthesia cycle monitoring system and empirical method.Changes in myocardial markers,inflammatory markers,and brain natriuretic peptide(BNP)levels were compared in four groups of patients during and 1 day after surgery.Renal function was compared among the four groups of patients at 7 days postoperatively.The incidence of adverse events(seizures,cerebral infarction,spinal motor impairment,myocardial infarction,cognitive dysfunction,and revascularization)in the four groups was then compared at 6 months of follow-up.Results:During surgery,Tn and CKMB in elderly study group were significantly lower than those in elderly conventional group(P<0.05),and Tn and CKMB in non-elderly study group were significantly lower than those in elderly study group(P<0.05).1 day after surgery,Tn in elderly study group was significantly lower than that in elderly conventional group and was significantly higher than that in non-elderly study group and non-elderly conventional group(P<0.05).Tn in non-elderly study group was significantly lower than that in elderly study group(P<0.05),and Tn in non-elderly study group was significantly lower than that in non-elderly conventional group(P<0.05).CK-MB in elderly study group was significantly lower than that in elderly routine group(P<0.05).The hs-CRP and BNP were significantly higher in elderly conventional group than those i
作者
詹锐
张晓琴
汪越
杨梅
钱伟
ZHAN Rui;ZHANG Xiao-qin;WANG Yue(Xuancheng People's Hospital,Xuancheng 242000,Anhui)
出处
《安徽医专学报》
2023年第2期23-25,共3页
Journal of Anhui Medical College
关键词
体感诱发电位
高龄
后天获得性病变
麻醉
somatosensory evoked potential
elderly
acquired lesions
anesthesia
