对肺移植患者认知功能障碍的轨迹和影响因素的纵向研究
Lei Cao1, Shugao Ye2, Yuan Chen2
1School of Nursing, Nanjing Medical University, Nanjing, China; Lung Transplant Center, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Nanjing, China.
Transplant immunology
|May 16, 2024
概括
肺移植患者的术后认知功能障碍 (POCD) 在六个月内呈现下降趋势,确定了明显的高风险和低风险轨迹. 关键的影响因素包括早期康复,疼痛,ICU住院和寒冷缺血时间.
科学领域:
- 移植医学 移植医学
- 神经科学是一个神经科学.
- 关键的护理关键的护理
背景情况:
- 肺移植可以改善末期肺病患者的生存率和生活质量.
- 手术后认知功能障碍 (POCD) 是一种已知的并发症,但对其异质性的纵向研究有限.
- 了解POCD轨迹对于优化移植后护理至关重要.
研究的目的:
- 评估影响肺移植受体术后认知功能障碍 (POCD) 的因素.
- 在肺移植后的六个月内确定不同的认知功能障碍子组轨迹.
- 确定POCD发展和进展的独立风险因素.
主要方法:
- 肺移植患者的前性纵向研究 (2022年9月 - 2023年9月).
- 使用蒙特利尔认知评估 (MoCA) 评估的认知功能在移植后的8天,1,3个月和6个月.
- 隐性类别增长模型 (LCGM) 分析用于识别POCD轨迹和子组;物流回归确定了风险因素.
主要成果:
- 认知功能得分 (MoCA NRS) 显示,移植后8天至6个月的增长趋势.
- 在LCGM分析中,发现了两种不同的POCD轨迹:高风险 (25.32%) 和低风险 (54.68%) 组.
- 早期康复,疼痛严重程度,ICU停留时间和供体肺冷性缺血时间显著影响POCD.
结论:
- 肺移植接受者在六个月内表现出认知功能障碍的整体下降趋势.
- 确定了POCD的两个不同的风险轨迹 (高和低),突出显示了患者的异质性.
- 早期术后康复,疼痛管理,减少ICU停留时间,并尽量减少捐赠者的肺缺血是缓解POCD的关键.
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