摘要
目的 探讨脑电双频指数(BIS)与胸腔镜肺癌根治术老年患者术后认知功能障碍(POCD)的关系。方法 回顾性分析228例接受胸腔镜肺癌根治术治疗老年患者的临床资料。术后7d内,83例发生POCD(POCD组),145例未发生POCD(对照组)。比较两组相关临床资料及麻醉诱导前(T0)、单肺通气开始前(T1)、手术15min(T2)和30min(T3)、双肺通气开始前(T4)和苏醒(T5)时的BIS。采用多因素logistic回归分析影响POCD的危险因素。结果 两组年龄、手术时间、受教育程度和合并高血压、糖尿病、高胆固醇血症比例比较差异有统计学意义(P<0.05)。POCD组在T2~T5时BIS和T1~T5时BIS平均值低于对照组(P<0.05)。多因素logistic回归分析结果显示,年龄>70岁、受教育程度低、手术时间长、T1~T5时BIS平均值低和合并高血压、糖尿病、高胆固醇血症均是胸腔镜肺癌根治术老年患者POCD的独立危险因素(P<0.05)。结论 术中及苏醒时BIS偏低容易导致胸腔镜肺癌根治术老年患者POCD。高龄、受教育程度低、手术时间长和合并高血压、糖尿病、高胆固醇血症均与POCD密切相关。
Objective To investigate the relationship between bispectral index(BIS)and postoperative cognitive dysfunction(POCD)in senile lung cancer patients undergoing thoracoscopic radical resection.Methods The clinical data of 228 senile lung cancer patients undergoing thoracoscopic radical resection were retrospectively analyzed.According to the occurrence of POCD within seven days after surgery,the patients were divided into POCD group(with POCD,83 cases)and control group(without POCD,145 cases).The clinical data and BIS of the two groups were compared before anesthesia induction(To),before the start of single lung ventilation(T1),15 minutes(T2)and 30 minutes(T3)after operation,before the start of double lung ventilation(T4)and after recovery(T5).Multivariate logistic regression was used to analyze the risk factors of POCD.Results There were significant differences in age,education level,operation time,and the percentages of the patients with hypertension,diabetes,hypercholesterolemia between the two groups(P<0.05).The BIS at T2-T5 and the average BIS value at T1-T5 of POCD group were lower than those of control group(P<0.05).Multivariate logistic regression analysis showed that age>70 years old,low education level,longer operation time,lower average BIS value at T1-T5,and complicated with hypertension,diabetes and hypercholesterolemia were the independent risk factors for POCD in senile lung cancer patients undergoing thoracoscopic radical resection(P<o.05).Conclusion Low BIS during surgery and after recovery easily leads to POCD in senile lung cancer patients undergoing thoracoscopic radical resection.Advanced age,low education level,long operation time,and complicated with hypertension,diabetes mellitus and hypercholesterolaemia are all closely associated with theoccurrenceof POCD.
作者
杨文静
刘存明
YANG Wenjing;LIU Cunming(Department of Anesthesia and Perioperative Medicine,First Affiliated Hospital,Nanjing Medical University,Nanjing 210029,CHINA)
出处
《江苏医药》
CAS
2024年第11期1089-1093,共5页
Jiangsu Medical Journal
基金
国家自然科学基金项目(BK20211382)。
关键词
脑电双频指数
胸腔镜肺癌根治术
术后认知功能障碍
老年
Bispectral index
Thoracoscopic radical resection of lung cancer
Postoperative cognitivedysfunction
Geriatrics
