目的研究心脏瓣膜置换术后早期认知功能障碍(P0CD)的发生与术中局部脑组织氧饱和度变化的关系。方法选取择期行心脏瓣膜置换术的患者82例,入手术室后监测脑氧饱和度(rSO2),记录基线值(rSO2base)、最小值(rSO2min)、相比基线降低的最大...目的研究心脏瓣膜置换术后早期认知功能障碍(P0CD)的发生与术中局部脑组织氧饱和度变化的关系。方法选取择期行心脏瓣膜置换术的患者82例,入手术室后监测脑氧饱和度(rSO2),记录基线值(rSO2base)、最小值(rSO2min)、相比基线降低的最大百分数(rSO2%max)和低于基线值20%的阈值下面积(AUT2O%)。分别于术前1d和术后7d采用神经心理学测试的方法评估患者的认知功能,根据评估结果分为POCD组和non-POCD组,比较2组rS02的差异。结果POCD组34例,non-POCD组48例,P0 C D发生率41.5%。POCD组rSO2%max、AUT20%均高于non-P0CD组,差异有统计学意义(P<0.05)。结论心脏瓣膜置换术后早期认知功能障碍的发生与术中局部脑组织氧饱和度的降低有关,术中尽量减少rS02低于基线值20%以下的暴露时间可能有助于减少POCD的发生。展开更多
目的探讨局部脑组织的氧饱和度对体外循环心脏手术患者术后谵妄的影响。方法选择2018年1月至2020年10月在我院行体外循环心脏手术患者60例的临床资料进行回顾性分析,其中30例未发生术后谵妄为对照组,30例发生术后谵妄为观察组。比较两...目的探讨局部脑组织的氧饱和度对体外循环心脏手术患者术后谵妄的影响。方法选择2018年1月至2020年10月在我院行体外循环心脏手术患者60例的临床资料进行回顾性分析,其中30例未发生术后谵妄为对照组,30例发生术后谵妄为观察组。比较两组术中不同时间点rSO;水平及术前术后MMSE评分。选择患者术中rSO;水平最低值与MMSE评分进行相关性分析。结果 (1)两组在体外循环复温时rSO;水平最低,随后逐渐回升,组内不同时间点比较,差异有统计学意义(P<0.05);观察组体外循环开始时、体外循环降温时、体外循环复温时、体外循环停机时、体外循环停机后30 min rSO;水平均显著高于对照组,差异有统计学意义(P<0.05)。(2)术后两组MMSE评分低于术前,差异有统计学意义(P<0.05);术后观察组MMSE评分显著高于对照组,差异有统计学意义(P<0.05)。(3)患者术中rSO;水平与术后MMSE评分呈显著正相关(r=0.921,P=0.000)。结论体外循环心脏手术后发生谵妄的患者术中rSO;有一个显著的下降过程,且患者术中rSO;最低值与MMSE评分有显著的相关性。展开更多
Objectives To evaluate the effects of white noise on pain-related cortical response,pain score,and behavioral and physiological parameters in neonates with procedural pain.Methods A double-blind,randomized controlled ...Objectives To evaluate the effects of white noise on pain-related cortical response,pain score,and behavioral and physiological parameters in neonates with procedural pain.Methods A double-blind,randomized controlled trial was conducted.Sixty-six neonates from the Neonatal Intensive Care Unit in a university-affiliated general hospital were randomly assigned to listen to white noise at 50 dB(experimental group)or 0 dB(control group)2 min before radial artery blood sampling and continued until 5 min after needle withdrawal.Pain-related cortical response was measured by regional cerebral oxygen saturation(rScO_(2))monitored with near-infrared spectroscopy,and facial expressions and physiological parameters were recorded by two video cameras.Two assessors scored the Premature Infant Pain Profile-Revised(PIPP-R)independently when viewing the videos.Primary outcomes were pain score and rScO_(2)during arterial puncture and 5 min after needle withdrawal.Secondary outcomes were pulse oximetric oxygen saturation(SpO_(2))and heart rate(HR)during arterial puncture,and duration of painful expressions.The study was registered at the Chinese Clinical Trial Registry(ChiCTR2200055571).Results Sixty neonates(experimental group,n=29;control group,n=31)were included in the final analysis.The maximum PIPP-R score in the experimental and control groups was 12.00(9.50,13.00),12.50(10.50,13.75),respectively(median difference−0.5,95%CI−2.0 to 0.5),and minimum rScO_(2)was(61.22±3.07)%,(61.32±2.79)%,respectively(mean difference−0.325,95%CI−1.382 to 0.732),without significant differences.During arterial puncture,the mean rScO_(2),HR,and SpO_(2)did not differ between groups.After needle withdrawal,the trends for rScO_(2),PIPP-R score,and facial expression returning to baseline were different between the two groups without statistical significance.Conclusion The white noise intervention did not show beneficial effects on pain-related cortical response as well as pain score,behavioral and physiological parameters in neonates with procedural pain.展开更多
文摘目的研究心脏瓣膜置换术后早期认知功能障碍(P0CD)的发生与术中局部脑组织氧饱和度变化的关系。方法选取择期行心脏瓣膜置换术的患者82例,入手术室后监测脑氧饱和度(rSO2),记录基线值(rSO2base)、最小值(rSO2min)、相比基线降低的最大百分数(rSO2%max)和低于基线值20%的阈值下面积(AUT2O%)。分别于术前1d和术后7d采用神经心理学测试的方法评估患者的认知功能,根据评估结果分为POCD组和non-POCD组,比较2组rS02的差异。结果POCD组34例,non-POCD组48例,P0 C D发生率41.5%。POCD组rSO2%max、AUT20%均高于non-P0CD组,差异有统计学意义(P<0.05)。结论心脏瓣膜置换术后早期认知功能障碍的发生与术中局部脑组织氧饱和度的降低有关,术中尽量减少rS02低于基线值20%以下的暴露时间可能有助于减少POCD的发生。
文摘目的探讨局部脑组织的氧饱和度对体外循环心脏手术患者术后谵妄的影响。方法选择2018年1月至2020年10月在我院行体外循环心脏手术患者60例的临床资料进行回顾性分析,其中30例未发生术后谵妄为对照组,30例发生术后谵妄为观察组。比较两组术中不同时间点rSO;水平及术前术后MMSE评分。选择患者术中rSO;水平最低值与MMSE评分进行相关性分析。结果 (1)两组在体外循环复温时rSO;水平最低,随后逐渐回升,组内不同时间点比较,差异有统计学意义(P<0.05);观察组体外循环开始时、体外循环降温时、体外循环复温时、体外循环停机时、体外循环停机后30 min rSO;水平均显著高于对照组,差异有统计学意义(P<0.05)。(2)术后两组MMSE评分低于术前,差异有统计学意义(P<0.05);术后观察组MMSE评分显著高于对照组,差异有统计学意义(P<0.05)。(3)患者术中rSO;水平与术后MMSE评分呈显著正相关(r=0.921,P=0.000)。结论体外循环心脏手术后发生谵妄的患者术中rSO;有一个显著的下降过程,且患者术中rSO;最低值与MMSE评分有显著的相关性。
基金This work was supported by grants from Guangdong Nurse Association[gdshsxh2021a058]Department of Science and Technology of Guangdong Province[2014A020212396].
文摘Objectives To evaluate the effects of white noise on pain-related cortical response,pain score,and behavioral and physiological parameters in neonates with procedural pain.Methods A double-blind,randomized controlled trial was conducted.Sixty-six neonates from the Neonatal Intensive Care Unit in a university-affiliated general hospital were randomly assigned to listen to white noise at 50 dB(experimental group)or 0 dB(control group)2 min before radial artery blood sampling and continued until 5 min after needle withdrawal.Pain-related cortical response was measured by regional cerebral oxygen saturation(rScO_(2))monitored with near-infrared spectroscopy,and facial expressions and physiological parameters were recorded by two video cameras.Two assessors scored the Premature Infant Pain Profile-Revised(PIPP-R)independently when viewing the videos.Primary outcomes were pain score and rScO_(2)during arterial puncture and 5 min after needle withdrawal.Secondary outcomes were pulse oximetric oxygen saturation(SpO_(2))and heart rate(HR)during arterial puncture,and duration of painful expressions.The study was registered at the Chinese Clinical Trial Registry(ChiCTR2200055571).Results Sixty neonates(experimental group,n=29;control group,n=31)were included in the final analysis.The maximum PIPP-R score in the experimental and control groups was 12.00(9.50,13.00),12.50(10.50,13.75),respectively(median difference−0.5,95%CI−2.0 to 0.5),and minimum rScO_(2)was(61.22±3.07)%,(61.32±2.79)%,respectively(mean difference−0.325,95%CI−1.382 to 0.732),without significant differences.During arterial puncture,the mean rScO_(2),HR,and SpO_(2)did not differ between groups.After needle withdrawal,the trends for rScO_(2),PIPP-R score,and facial expression returning to baseline were different between the two groups without statistical significance.Conclusion The white noise intervention did not show beneficial effects on pain-related cortical response as well as pain score,behavioral and physiological parameters in neonates with procedural pain.
