不同通风模式对老年患者手术后认知功能障碍的影响,这些老年患者接受了腹腔镜腹壁
Yu-Long Jia1,2, Xiao-Yu Zhang1,2, Chen-Xu Chou2
1Baotou Medical College Baotou 014040, Inner Mongolia Autonomous Region, China.
International journal of clinical and experimental pathology
|September 18, 2025
概括
在接受修复的老年患者中,压力调节体积控制通风 (PRVC) 降低了术后认知功能障碍 (POCD). 这种通风策略通过改善呼吸机制和减少炎症来提供神经保护.
科学领域:
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
- 老年医学 老年医学
背景情况:
- 手术后认知功能障碍 (POCD) 是接受手术的老年患者的一个重大问题.
- 腹腔镜腹壁的修复在老年人群中很常见.
- 手术期间的通风策略可能会影响POCD的结果.
研究的目的:
- 为了比较压力控制通风 (PCV),体积控制通风 (VCV) 和压力调节体积控制通风 (PRVC) 对老年患者的POCD的影响.
- 调查与不同通风模式相关的潜在生理和炎症机制.
主要方法:
- 一项前性研究涉及485名接受腹腔镜腹壁修复的老年患者.
- 随机分配到PCV,VCV或PRVC组中.
- 使用MMSE和MoCA评估认知功能;测量了脑损伤和炎症的生理参数和生物标志物.
主要成果:
- 在手术后的第三天,POCD的发病率在PRVC组明显低于PCV组.
- PRVC与改善动态肺部服从性和减少视神经外直径有关.
- PRVC显著降低了炎症性细胞因子IL-1β和IL-6的血度.
结论:
- 在接受腹壁椎修复的老年患者中,PRVC通风是减少早期POCD的首选策略.
- PRVC的神经保护作用可能是由改善的呼吸机制和减少的全身炎症反应介导的.
- 对优化易受伤害的患者群体通风策略的进一步研究是有必要的.
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