The application of target-oriented management of regional cerebral oxygen saturation monitoring in gastrointestinal surgery of elderly patients with fragile brain function
10.3760/cma.j.cn115455-20231229-00640
- VernacularTitle:局部脑氧饱和度监测目标导向管理在老年脆弱脑功能患者胃肠手术中的应用
- Author:
Wenjuan LI
1
;
Guoping WANG
1
Author Information
1. 长治市人民医院麻醉科，长治 046000
- Publication Type:Journal Article
- Keywords:
Aged;
Regional cerebral oxygen saturation;
Fragile brain function;
Gastrointestinal surgery
- From:
Chinese Journal of Postgraduates of Medicine
2025;48(4):331-335
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect of target-oriented management of regional cerebral oxygen saturation (rScO 2) monitoring on gastrointestinal surgery in elderly patients with fragile brain function. Methods:A total of 60 elderly patients with fragile brain functional surgery admitted to Changzhi People′s Hospital from January 2022 to December 2022 were divided into the study group and the conventional group by the random number table method, each group with 30 cases, rScO 2 monitoring target-oriented management and conventional anesthesia monitoring management were given respectively during the operation. The levels of mean arterial pressure (MAP), blood gas analysis and cerebral oxygen metabolism indexes were compared between the two groups at different time points. Postoperative recovery related indexes and the incidence of postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) were recorded and compared between the two groups. Results:The level of MAP at 30 min after anesthesia in the study group was significantly higher than that in the conventional group: (90.50 ± 6.03) mmHg vs. (82.05 ± 6.10) mmHg, 1 mmHg = 0.133 kPa, there was statistical difference ( P<0.05). The levels of blood lactic acid (Lac) and blood glucose (GLU) at 60 min and immediately after surgery in the study group were lower than those in the conventional group: (1.45 ± 0.48) mmol/L vs. (1.90 ± 0.51) mmol/L, (1.34 ± 0.42) mmol/L vs. (1.65 ± 0.46) mmol/L; (7.17 ± 0.90) mmol/L vs. (7.62 ± 0.76) mmol/L, (6.70 ± 0.87) mmol/L vs. (7.11 ± 0.67) mmol/L, there were statistical differences ( P<0.05). The jugular veinoxygen content (CjvO 2) at 60 min after operation in the study group was higher than that in the conventional group: (98.16 ± 20.34) ml/L vs. (85.32 ± 18.54) ml/L; cerebral extraction rate of oxygen (CERO 2) and the internal jugular veno-arterial blood lactic acid difference (Djv-aLac) were lower than those in the conventional group: (33.00 ± 7.86)% vs. (40.52 ± 9.05)%, (0.15 ± 0.05) mmol/L vs. (0.21 ± 0.07) mmol/L, there were statistical differences ( P<0.05). The recovery time, tracheal extubation time and hospital stay in the study group were lower than those in the conventional group: (12.25 ± 2.00) min vs. (15.00 ± 3.14) min, (14.00 ± 2.34) min vs. (20.12 ± 4.37) min, (9.00 ± 1.13) d vs. (9.65 ± 1.25) d, there were statistical differences ( P<0.05). The POD incidence in the study group was lower than that in the conventional group: 6.67%(2/30) vs. 26.67%(8/30), there was statistical difference ( χ2 = 4.32, P<0.05). The incidence of POCD within 1 week after surgery had no statistical difference between the two groups ( P>0.05). Conclusions:rScO 2 monitoring and target-oriented management can better maintain the stability of hemodynamics and cerebral oxygen metabolism in elderly patients with fragile brain function, and can improve blood gas analysis index, reduce the occurrence of postoperative POD and other cognitive abnormalities, which is beneficial to their postoperative outcome.
