脑血管调节失调和手术后的认知变化,在 carotid endarterectomy 之后
Ágnes Dóra Sándor1, Zsófia Czinege2, András Szabó3
1Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary.
GeroScience
|June 14, 2024
概括
Carotid Endarterectomy 可能会影响认知功能. 在手术期间的近红外光谱 (NIRS) 监测显示,大脑组织和度的降低与术后认知能力的下降和改善有关.
科学领域:
- 神经外科 神经外科
- 认知神经科学 认知神经科学
- 医疗技术 医疗技术 医学技术
背景情况:
- 关于手术后认知功能的关节内关节切除术 (CEA) 结果仍在争论中.
- 在CEA期间对大脑组织氧化监测对于理解认知影响至关重要.
研究的目的:
- 通过近红外光谱学 (NIRS) 测量的大脑组织和度与CEA后认知功能变化之间的关联.
- 在接受CEA的患者中确定术后神经认知衰退 (PNCD) 和术后认知改善 (POCI) 的预测因子.
主要方法:
- 对103名在全身麻醉下接受选择性CEA的无症状患者的术后数据的分析.
- 使用迷你精神状态检查 (MMSE) 和蒙特利尔认知评估 (MoCA) 在手术前和手术后3个月进行认知评估.
- 使用NIRS进行大脑监测,以确定最低区域大脑氧和 (rSO2) 值和脱度.
主要成果:
- 在35.92%的患者中出现了术后神经认知衰退 (PNCD),而在17.47%的患者中观察到术后认知改善 (POCI).
- 女性性别,糖尿病和更高的脱度与PNCD独立相关.
- 在紧过程中脱度与MoCA得分变化之间存在显著的负相关性 (R = -0.707,p = 0.001). 具体的脱度值预测了PNCD和POCI.
结论:
- 在关节交叉紧过程中,大脑组织和与术后认知功能变化有显著的关系,特别是通过MoCA测试评估的变化.
- NIRS监测可以帮助识别患有CEA后认知变化风险的患者.
- 了解大脑氧化和认知结果之间的关系可以为缓解认知衰退的手术策略提供信息.
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