中国医科大学学报

中国医科大学学报

中国医科大学学报

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低血红蛋白对全麻患者脑氧饱和度及术后认知功能的影响

黄昕,滕秀飞,杨延超,李秀艳,魏巍,朱俊超   

  1. 中国医科大学附属盛京医院麻醉科,沈阳110004
  • 收稿日期:2015-06-15 出版日期:2016-01-05 发布日期:2015-12-30
  • 通讯作者: 朱俊超,E-mail:zhujc@sj?hospital.org
  • 作者简介:黄昕(1991 -),女,硕士研究生.
  • 基金资助:

    辽宁省自然科学基金(20102282)

Effect of Low Hemoglobin on Patients′Cerebral Oxygen Saturation and Postoperative Cognitive Dysfunction under General Anesthesia

HUANG Xin,TENG Xiu-fei,YANG Yan-chao,LI Xiu-yan,WEI Wei,ZHU Jun-chao   

  1. Department of Anesthesiology,ShengjingHospital,China Medical University,Shenyang110004,China
  • Received:2015-06-15 Online:2016-01-05 Published:2015-12-30

摘要:

目的 评价低血红蛋白(Hb)对全麻患者的脑氧饱和度以及术后认知功能的影响。方法 选取行择期全麻开腹妇科手术女性患者40例。根据患者Hb分为N组和D组,各20例;保持脑电双频指数(BIS)相同的情况下观察2组脑氧饱和度以及术后认知功能障碍发生率之间的差异。分别记录2组患者在手术中各时刻的平均动脉压、心率、血氧饱和度、BIS、脑氧饱和度以及腋温以及呼吸末二氧化碳浓度。并记录术前1 d、术后1 d以及术后3 d的蒙特利尔认知评估量表数值。结果 与N组比较,D组患者在各观察时间点的脑氧饱和度,以及术后认知功能障碍评分较低,且术后认知功能障碍发生率较高。结论 Hb可以影响脑氧饱和度,低Hb患者的脑氧饱和度较低,并且术后早期认知功能障碍的发生率较高。

关键词: 脑氧饱和度, 血红蛋白浓度, 术后认知功能障碍, 近红外光谱技术

Abstract:

Objective To evaluate the effect of low hemoglobin on patientscerebral oxygen saturation and postoperative cognitive dysfunction under general anesthesia. Methods Forty female patients of ASA physical statustoⅡ,scheduled for elective open abdominal gynecologic operation under general anesthesia were recruited for the study. All the patients aged between 50 and 65from which twenty of them have a hemoglobin concentration of 12-13 g/dLreferred as N groupthe other twenty patients have a hemoglobin concentration of 8-9 g/dLreferred as D group. The two groups all underwent sevoflurane and remifentanil intravenous-inhalation combined anesthesiaassure the two groupss average end-tidal sevoflurane concentration was of 1.0 MAC and assure the two groups were of the same BIS value during operation. Then the discrepancy of cerebral oxygen saturation and the incidence rate of post operative cognitive dysfunctionPOCDbetween the two groups was observed. At the time of entering the operation roomT0),3 min after O2 inhalationT1),start of operationT2),10 min afterT3),20 min afterT4),30 min afterT5),the end of operationT6),and 5 min after extubation and fully palinesthesiaT7),the following variables were respectively recordedmean arterial pressure MAP),heart rateHR),oxygen saturationSpO2),BIScerebral oxygen saturationrSO2),axillary temperatureT),and end-tidal carbon dioxideEtCO2. Record the score of MOCA on the day before operationthe day after operation and 3 days after operation. Results The cerebral oxygen saturation at T0T2-T7 observation points as well as the grading score of POCD were significantly lower in D groupP < 0.05and the incidence rate of POCD was significantly higher in D group compared to N groupP < 0.05. Conclusion Hemoglobin concentration can affect cerebral oxygen saturationand the cerebral oxygen saturation in patients with low hemoglobin was lower and the incidence rate of POCD was higher.

Key words: cerebral oxygen saturation, hemoglobin concentration, postoperative cognitive dysfunction, near?infrared spectroscopy

中图分类号: 

  • R614.2
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