动态监测脑血流及脑氧饱和度对沙滩椅位肩关节镜手术后缺血性脑损伤的影响

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摘要目的探讨动态监测脑血流及脑氧饱和度对预防沙滩椅位肩关节镜手术后缺血性脑损伤的临床效果。方法选取2014年5月~2016年8月在深圳市第二人民医院进行沙滩椅位肩关节镜手术患者48例作为研究对象，按照简单随机法将患者分为对照组和观察组，每组各24例。对照组术中监测指端血压及氧饱和度，观察组术中监测脑血压及脑氧饱和度。比较两组患者手术情况、术后7 d ULCA评分、血压及血氧饱和度变化、术后简易精神状态量表（MMSE）评分。结果两组患者手术时间、术中出血量、术后引流量及术后拔管时间差异无统计学意义（P > 0.05）。观察组患者术后7 d ULCA评分优良率（87.50%）与对照组（91.67%）差异无统计学意义（P > 0.05）。两组患者术后血压及血氧饱和度均明显下降，差异有统计学意义（P < 0.05）；观察组患者术后血压及血氧饱和度均高于对照组，差异有统计学意义（P < 0.05）。两组患者术后MMSE评分均有下降，但是观察组患者MMSE评分明显高于对照组，差异有统计学意义（P < 0.05）。结论进行沙滩椅位肩关节镜手术时，动态检测脑血流及脑氧饱和度，可有效降低缺血脑损伤的发生风险，提高患者术后恢复。

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	陈静霞赵昭

关键词 ：脑血流量, 脑氧饱和度, 沙滩椅位, 肩关节镜, 缺血性脑损伤

Abstract：Objective To investigate the clinical effect of dynamic monitoring of cerebral blood flow and cerebral oxygen saturation on prevention of ischemic brain injury after arthroscopic surgery of beach chair shoulder. Methods From May 2014 to August 2016, 48 cases of undergoing arthroscopic shoulder surgery patients was selected in Shenzhen Second People′s Hospital. According to the simple random method they were divided into control group and observation group, with 24 cases in each group. The blood pressure and oxygen saturation were monitored during the operation in the control group and monitoring of cerebral blood pressure and cerebral oxygen saturation in the observation group was carried out. The operation situation, ULCA score 7 d after operation, blood pressure and blood oxygen saturation, and MMSE score were compared between two groups. Results There was no significant difference between the two groups in operation time, intraoperative blood loss, postoperative drainage volume and postoperative extubation time (P > 0.05). In the observation group, the excellent and good rate of ULCA score (87.50%) at 7 d after operation was not significantly different from that of the control group (91.67%) (P > 0.05). The postoperative blood pressure and blood oxygen saturation of patients in the two groups were decreased, the differences were statistically significant (P < 0.05). The postoperative blood pressure and blood oxygen saturation of patients in the observation group were higher than those in the control group, the differences were statistically significant (P < 0.05). The postoperative MMSE scores of patients in the two groups were decreased, but the MMSE score of the observation group was significantly higher than that of the control group, the difference was statistically significant (P < 0.05). Conclusion The dynamic detection of cerebral blood flow and cerebral oxygen saturation can effectively reduce the risk of ischemic brain injury and improve the recovery of patients after undergoing arthroscopic surgery.

Key words： Cerebral blood flow Cerebral oxygen saturation Beach chair Shoulder arthroscopy Ischemic brain injury

基金资助: 广东省医学科学技术研究基金项目（B2015113）。

引用本文:

陈静霞赵昭 . 动态监测脑血流及脑氧饱和度对沙滩椅位肩关节镜手术后缺血性脑损伤的影响[J]. 中国医药导报, 2018, 15(4): 82-85.
CHEN Jingxia ZHAO Zhao. Clinical study of dynamic monitoring of cerebral blood flow and cerebral oxygen saturation in prevention of ischemic brain injury after arthroscopic surgery of beach chair shoulder. 中国医药导报, 2018, 15(4): 82-85.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2018/V15/I4/82

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