局部脑氧饱和度监测的基线水平及其影响因素分析

Study on baseline level of regional cerebral oxygen saturation and its influence factors

目的:探讨脑氧饱和度(rSO_(2))的基线水平监测及其影响因素。方法:选取医院收治的101例择期手术患者,101例患者存在4类并发症,按照并发症类型相对应的分为糖尿病组(46例)和非糖尿病组(55例);高血压组(57例)和非高血压组(44例);贫血组(25例)和非贫血组(76例);有糖尿病并发症的疮疡科组(46例)和无糖尿病并发症的非疮疡科组(55例)。对101例患者的术前基本情况、既往病史及rSO_(2)基线值进行相关分析,监测并比较糖尿病组与非糖尿病组(包括比较其中的糖尿病病史≤10年与>10年的患者)、疮疡科组与非疮疡科组、高血压组与非高血压组、贫血组与非贫血组以及年龄<60岁与≥60岁患者rSO_(2)基值差异;对术前基本资料与rSO_(2)基线进行相关分析和多元线性回归分析。结果:糖尿病组患者左、右侧rSO_(2)基线值均小于非糖尿病组,差异有统计学意义(t=-4.251,t=-3.881;P<0.05),而其中糖尿病病程>10年患者左、右侧rSO_(2)基线值均小于病程≤10年患者;有糖尿病并发症的疮疡科组患者左、右侧rSO_(2)基线值均低于无糖尿病并发症的非疮疡科组,差异有统计学意义(t=-3.834,t=-3.566;P<0.05);高血压组患者左、右侧rSO_(2)基线值均小于非高血压组,差异有统计学意义(t=-2.743,t=-2.008;P<0.05);年龄≥60岁老年患者左侧rSO_(2)基线值小于年龄<60岁患者,差异有统计学意义(t=2.072,P<0.05)。糖尿病、糖尿病病程、糖尿病并发症和年龄对左、右侧rSO_(2)基线值影响的相关性显著(r=-0.4,r=-0.3,r=0.3,r=-0.2;P<0.05)。结论:手术前合并糖尿病,糖尿病病史时间长,糖尿病并发症,高龄使患者rSO_(2)明显降低。

Objective:To explore the monitor on baseline level of cerebral oxygen saturation and its influence factors.Methods:A total of 101 patients scheduled for surgery in hospital were selected.According to the types of complication that existed in 101 patients,they were divided into diabetes group(46 cases)and non-diabetes group(55 cases),hypertension group(57 cases)and non-hypertension group(44 cases),anemia group(25 cases)and non-anemia group(76 cases),specialty of carbuncle and ulcers with the complication of diabetes group(46 cases)and non-specialty of carbuncle and ulcers with the complication of diabetes group(55 cases).The preoperatively basic conditions,past medical history and rSO_(2) baseline values of 101 patients were used to implement correlation analysis.The differences of rSO_(2) between diabetes group and non-diabetes group(included between the diabetes histories of patients were less than or equal to 10 years and those were larger than 10 years),and between specialty of carbuncle and ulcers group and non-specialty of carbuncle and ulcers group,and between hypertension group and non-hypertension group,and between anemia group and non-anemia group,and between patients whose ages were less than 60 and those whose ages were larger or equal to 60 were monitored and compared.The preoperatively basic data and rSO_(2) baseline value were analyzed by correlation analysis and multiple linear regression.Results:The rSO_(2) baseline values of left and right sides of diabetes group were significantly less than those of non-diabetes group(t=-4.251,t=-3.881,P<0.05),respectively.Among of them,the rSO_(2) baseline values of left and right sides of patients whose duration of diabetes were more than 10 years were less than those of patients whose duration of diabetes were less than or equal to 10 years.The rSO_(2) baseline values of left and right sides of ulcer group with diabetic complications were significantly lower than those of non-ulcer group without diabetic complications(t=-3.834,t=-3.566,P<0.05),respectively.The rSO_(2) baseline values of left and right sides in hypertension group were significantly less than those in non-hypertension group(t=-2.734,t=-2.008,P<0.05),respectively.And the rSO_(2) baseline values of left side in patients whose ages were larger than or equal to 60 years old were significantly less than those in patients whose ages were less than 60 years old(t=2.072,P<0.05).Multiple linear regression analysis showed that diabetes,duration of diabetes,diabetic complications,age were significantly correlative with the rSO_(2) baseline values of left and right sides(r=-0.4,r=-0.3,r=0.3,r=-0.2,P<0.05),respectively.Conclusion:Preoperative combination with diabetes,long duration of diabetes,diabetic complications and old age can significantly reduce the rSO_(2) baseline value of patients.