老年患者围手术期局部脑氧饱和度监测与术后认知功能障碍的研究现状

Present research on peri-operative regional cerebral oxygen saturation monitoring and postoperative cognitive dysfunction in elderly patients

老年患者神经功能下降明显,术中脑氧供需平衡易发生紊乱,巨术中脑氧饱和度(ScO2)下降与术后认知功能障碍(POCD)存在一定联系.基于红外线光谱(NIRS)技术的局部脑氧饱和度(rScO2)作为一种新型无创监测脑氧供需平衡的方法,以其可以及时发现缺血缺氧及脑灌注变化情况的优点,正在临床被广泛应用.现从rScO2变化与POCD发生间的联系以及rScO2检测原理等方面,回顾性概述该方法在老年患者围手术期中的应用和目前存在的问题.

The neurological function of elderly patients is significantly decreased,their balance of cerebral oxygen supply and demand is prone to disorder,during an operation,the decline of intra-operative cerebral oxygen saturation(ScO2)has certain relationship with the postoperative cognitive dysfunction(POCD).The regional cerebral oxygen saturation(rScO2)degree surveillance is recognized as a novel non-invasive method for monitoring the balance of cerebral oxygen supply and demand,based on near-infrared spectroscopy(NIRS)with its advantages of detecting ischemia/hypoxia and cerebral perfusion changes in time,it is widely being used in clinical practice.In this article,from the association between the changes of rScO2 and occurrence of POCD,the principle of rScO2 detection,etc aspects,the application of this method in the peri-operative period of elderly patients and the present existing problems were summarized retrospectively.