腹腔镜胃癌根治术老年患者脑氧饱和度与术后认知功能障碍的关系

Relationship between regional cerebral oxygen saturation and postoperative cognitive dysfunction in elderly patients undergoing laparoscopic radical gastrectomy for gastric cancer

付宏博 ¹张锋²

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作者信息

1. 西藏民族大学附属医院麻醉科,陕西咸阳,712082
2. 西安航天总医院普通外科,陕西西安,710100
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摘要

目的探讨并分析腹腔镜胃癌根治术老年患者脑氧饱和度(rSO2)与术后认知功能障碍的关系.方法选取2019年6月至2023 年 6月收治的86 例行腹腔镜胃癌根治术的老年患者为研究对象,根据是否发生认知功能障碍将其分为认知功能障碍组和认知功能正常组.比较两组的一般资料及rSO2;分析rSO2 与术后认知功能障碍的关系.结果 86 例患者中,发生认知功能障碍患者 31 例,未发生认知功能障碍患者 55 例;气腹60 min(T2)～苏醒时(T5),认知功能障碍组的rSO2 低于认知功能正常组(P＜0.05).两组的年龄、高血压、糖尿病、高胆固醇血症、rSO2、术中平均动脉压(MAP)比较,差异具有统计学意义(P＜0.05).多因素Logistic回归分析结果显示,年龄＞70岁、高血压、糖尿病、高胆固醇血症、rSO2 低、术中MAP高是腹腔镜胃癌根治术老年患者术后认知功能障碍的独立危险因素(P＜0.05).结论 rSO2 与腹腔镜胃癌根治术老年患者术后认知功能障碍密切相关,rSO2 低容易导致术后认知功能障碍,同时年龄、高血压、糖尿病、高胆固醇血症、术中MAP也与术后认知功能障碍有关.

Abstract

Objective To investigate and analyze the relationship between regional cerebral oxygen saturation(rSO2)and postoperative cognitive dysfunction in elderly patients undergoing laparoscopic radical gastrectomy for gastric cancer.Methods A total of 86 elderly patients who underwent laparoscopic radical gastrectomy for gastric cancer from June 2019 to June 2023 were selected as the research objects.According to whether cognitive dysfunction occurred,the patients were divided into cognitive dysfunction group and normal cognitive function group.The general data and rSO2 of the two groups were compared;the relationship between rSO2 and postoperative cognitive dysfunction was analyzed.Results Among the 86 patients,there were 31 patients with cognitive dysfunction and 55 patients without cognitive dysfunction;from 60 min of pneumoperitoneum(T2)to recovery(T5),the rSO2 in the cognitive dysfunction group was lower than that in the normal cognitive function group(P<0.05).There were significant differences in age,hypertension,diabetes,hypercholesterolemia,rSO2,and intraoperative mean artery pressure(MAP)between the two groups(P<0.05).Multivariate Logistic regression analysis results showed that age>70 years,hypertension,diabetes,hypercholesterolemia,low rSO2,and high intraoperative MAP were independent risk factors for postoperative cognitive dysfunction in elderly patients undergoing laparoscopic radical gastrectomy for gastric cancer(P<0.05).Conclusion rSO2 is closely related to postoperative cognitive dysfunction in elderly patients undergoing laparoscopic radical gastrectomy for gastric cancer,low rSO2 can easily lead to postoperative cognitive dysfunction.At the same time,age,hypertension,diabetes,hypercholesterolemia,and intraoperative MAP are also related to postoperative cognitive dysfunction.

关键词

腹腔镜胃癌根治术/脑氧饱和度/认知功能障碍/胃癌

Key words

laparoscopic radical gastrectomy for gastric cancer/regional cerebral oxygen saturation/cognitive dysfunction/gastric cancer

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出版年

2024

临床医学研究与实践

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