中国体外循环杂志2019，Vol.17Issue(1)：26-31,40,7.DOI:10.13498/j.cnki.chin.j.ecc.2019.01.07
体外循环心脏手术中脑组织氧饱和度最低值与术后认知功能障碍相关性分析
Association between cognitive dysfunction after cardiac surgery under cardiopulmonary bypass and the intraoperative lowest level of regional cerebral oxygen saturation
常昕 1郭震 2施丹 2徐花 2邹良建2
作者信息
- 1. 海军军医大学附属长海医院心血管外科 200433 上海
- 2. 上海交通大学附属胸科医院心外科 200030 上海
- 折叠
摘要
Abstract
Objective To investigate whether the lowest regional cerebral oxygen saturation (rScO2) value during cardiopulmonary bypass (CPB) was associated with postoperative cognitive dysfunction (POCD) and to evaluate the risk factors of POCD. Methods The rScO2 levels of 109 patients undergoing elective cardiac valve surgery were maintained during operation, with the baseline value greater than 80％ and the absolute value higher than 55％. The lowest value of rScO2 was recorded, together with the duration of CPB, aortic crossclamp time, the lowest hemoglobin value, red blood cell transfusion, postoperative mechanical ventilation time, postoperative ICU stay, postoperative hospital stay, CRRT treatment and major organ complications. Two tests of cognitive assessment were conducted the day before surgery and at the 4 th day after the surgery. POCD was diagnosed if the decrease of cognitive score after the surgery was greater than 4 in any item of the two tests. Results In the 88 patients who finished the whole test schedule, 25 (28.4％) developed POCD. The lowest rScO2 value during surgery was associated with POCD. The ability to perform the tests was impacted by educational level. Conclusion During cardiac surgery, the lowest rScO2 value was associated with POCD. However, further research was needed to confirm the optimal rScO2 safety range to reduce the incidence of POCD.关键词
体外循环/心脏手术/术后认知功能障碍/脑氧饱和度/认知功能评估/危险因素Key words
Cardiopulmonary bypass/Cardiac surgery/Postoperative cognitive dysfunction/Cerebral oxygen saturation/Cognitive function assessment/Risk factor引用本文复制引用
常昕,郭震,施丹,徐花,邹良建..体外循环心脏手术中脑组织氧饱和度最低值与术后认知功能障碍相关性分析[J].中国体外循环杂志,2019,17(1):26-31,40,7.
