单肺通气手术患者POCD危险因素分析

Analysis on risk factors of POCD after one-lung ventilation

目的探讨单肺通气手术患者发生术后认知功能障碍(POCD)的患病率及其危险因素。方法选取60例42～83岁需单肺通气手术患者,于术前1 d和术后7 d分别接受简易智能状态检测,记录手术前后认知功能的改变,并分析围术期因素与患者发生POCD的关系。结果 14例患者发生POCD,患病率为23.3%。年龄增长与POCD的发生呈正相关,单肺通气后脑氧饱和度较基础值下降和乳酸升高值与患者POCD的发生呈正相关。结论单肺通气POCD的患病率为23.3%,年龄增长、乳酸值升高和脑氧饱和度较基础值下降是单肺通气的胸外科手术患者发生POCD的危险因素。

Objective To analyze the incidence and risk factors of postoperative cognitive dysfunction（POCD） in the patients undergoing one-lung ventilation.Methods Mini mental state examination was performed in 60 patients aged 42-83 years old 1d before operation and on the 7d after operation to evaluate the changes of cognitive function.The relations between perioperative risk factors and POCD were analyzed.Results POCD was present in 14 of the 60 patients.The incidence of POCD was 23.3%.There was a positive correlation between age and the incidence of POCD.Accumulation of lactate after one-lung ventilation and the drop of cerebral oxygen saturation were positively correlated with POCD.Conclusion The incidence of POCD was 23.3%.Age,the accumulation of lactate after one-lung ventilation and the drop of cerebral oxygen saturation are the risk factors for POCD in patients undergoing one-lung ventilation.