脑氧饱和度监测目标导向技术在老年患者围术期脑保护中的作用

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Abstract Objection To observe the effect of cerebral oxygen saturation (rSO2) monitoring goal-oriented technique on perioperative cerebral protection in elderly patients. Methods A total of 60 elderly patients who were scheduled to undergo elective non-cardiac surgery in the 900th Hospital of the Joint Logistics Support Force of the People’s Liberation Army from March 2019 to April 2020 were included in this study. They were devided into rSO2 monitoring group (group S) and routine group (group N) by random number table method, with 30 cases in each group. When rSO2 in group S decreased more than 13%, timely intervention was performed by raising blood pressure, increasing inhaled oxygen concentration, adjusting hemoglobin level and other methods to maintain rSO2 in the baseline range as far as possible. In group N, only cerebral oxygen saturation was monitored without clinical intervention. The decrease amplitude and duration of rSO2 during operation, the incidence of postoperative nervous system complications, and the changes of serum cortisol and S-100β were compared between the two groups. Results The incidence of mild and moderate cerebral hypoxia in group N was higher than that in group S; the area under curve of rSO2 decreased more than 13% in was significantly greater than that in group S (P ＜ 0.05), there was no significant difference in the incidence of delayed awakening between the two groups (P ＞ 0.05). The incidence of postoperative delirium in group N was significantly higher than that in group S (P ＜ 0.05). Postoperative montreal cognitive assessment scale (MoCA) scores in both groups were lower than those before surgery, and MoCA scores in group N were significantly lower than those in group S (P ＜ 0.05). The levels of serum cortisol and S-100β after operation were higher than those before operation (P ＜ 0.05). There was no significant difference in serum cortisol content between the two groups after operation (P ＞ 0.05). Serum S-100β content in group N was higher than that in group S (P ＜ 0.05). Conclusion The use of rSO2 monitoring goal-oriented technique can effectively avoid long-term cerebral hypoxia exposure of patients, thus preventing the occurrence of postoperative nervous system complications, and has a brain protection effect.

Key words： Cerebral oxygen saturation Elderly Neuroprotection Delirium Cognitive function

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	SU Xiuzhu ZHANG Yan WANG Liping

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SU Xiuzhu ZHANG Yan WANG Liping. Effect of goal-oriented technique of cerebral oxygen saturation monitoring on perioperative cerebral protection in elderly patients[J]. 中国医药导报, 2021, 18(7): 95-98,112.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2021/V18/I7/95

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