优化大脑氧和对手术后痴呆症的效果,对老年患者进行一个肺通风,以进行胸腔镜手术
Peilan Teng1,2, Henghua Liu1, Derong Xu1
1Department of Anesthesiology, Ganyu Hospital Affiliated to Kangda College of Nanjing Medical University, Lianyungang, China.
The Journal of international medical research
|September 14, 2024
概括
以区域大脑氧化和 (rScO2) 为指导的肺保护性通风在接受胸部手术的老年人中显著降低了术后妄想 (POD). 这一策略改善了大脑的氧化,并降低了POD发生率.
科学领域:
- 麻醉学 麻醉学
- 临界护理医学 临界护理医学
- 神经外科 神经外科
背景情况:
- 手术后痴呆症 (POD) 是经过胸部手术的老年人常见的并发症.
- 肺保护性通风策略旨在在单肺通风 (OLV) 过程中尽量减少肺损伤.
- 区域大脑氧化和 (rScO2) 监测可能为手术期间的大脑氧化提供见解.
研究的目的:
- 调查rScO2引导的肺保护性通风策略是否能改善大脑氧化,并减少65岁以上患者的POD发病率.
- 为了比较标准肺防护通风 (PV) 组与rScO2导向肺防护通风 (TPV) 组的结果.
主要方法:
- 一项随机对照试验,涉及120名接受OLV胸部手术的患者.
- 患者被随机分配到PV组或TPV组.
- 在手术期间监测rScO2,并在手术后评估POD发生情况.
主要成果:
- 3天内POD的发生率在TPV组 (8.5%) 与PV组 (23.3%) 相比显著较低.
- 与POD相关的生物指标 (S100β,NSE,TNF-α) 在TPV组下降.
- 在手术期间,TPV组的最低和平均rScO2水平较高.
结论:
- 持续的手术内rScO2监测和有针对性的干预措施对于增强大脑代谢至关重要.
- 这一策略有效地降低了老年手术患者手术后妄想症的风险.
- rScO2引导呼吸是一种有前途的方法,可以改善胸部手术后的神经结果.
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