Risk factors for postoperative short-term cognitive dysfunction in patients undergoing carotid endar-terectomy
10.3760∕cma.j.issn.0254-1416.2019.06.010
- VernacularTitle:颈动脉内膜剥脱术患者术后短期认知障碍的危险因素
- Author:
Limin ZHANG
1
;
Yanchao PENG
;
Rui LI
;
Mingli WANG
;
Yali MA
;
Xingliao LUO
Author Information
1. 沧州市中心医院麻醉科 061001
- Keywords:
Cognition disorders;
Risk factors;
Endarterectomy;
carotid
- From:
Chinese Journal of Anesthesiology
2019;39(6):676-679
- CountryChina
- Language:Chinese
-
Abstract:
Objective To identify the risk factors for postoperative short-term cognitive dysfunction ( STCD) in the patients undergoing carotid endarterectomy. Methods A total of 158 patients with carotid artery stenosis, aged≥18 yr, without preoperative cognitive dysfunction, undergoing carotid endarterecto-my from January 1, 2014 to May 30, 2017 in our hospital, were selected. Factors including age, sex, height, weight, education, presurgical complications ( hypertension, type Ⅱ diabetes mellitus, myocar-dial infarction and brain infarction) , degree of internal carotid artery stenosis, preoperative mean arterial pressure ( MAP ) , amount of dexmedetomidine, duration of operation, time of carotid artery occlusion, MAP during occlusion period, intraoperative volume of fluid infused ( crystalloid solution and colloid solu-tion), urine volume, blood loss, significant change in electroencephalogram (EEG) and visual analogue scale scores at 24 h after surgery were collected. Mini-Mental State Examination was used to evaluate the cognitive function at 24 h after surgery. The patients were divided into STCD group and non-STCD group ac-cording to whether or not patients developed postoperative STCD. The risk factors of which P values were less than 0. 05 would enter the bivariate logistic regression analysis to stratify the risk factors for postopera-tive STCD. Results Forty-nine patients developed postoperative STCD ( 31. 0％) . The intraoperative a-mount of colloid solution infused＜5 ml/kg, increase in MAP＜20％ of the baseline value during the occlu-sion period, and significant change in EEG during the occlusion period were independent risk factors for postoperative STCD ( P＜0. 05) . Conclusion The intraoperative amount of colloid solution infused＜5 ml/kg, increase in MAP＜20％ of the baseline value during the occlusion period, and significant change in EEG during the occlusion period are independent risk factors for postoperative STCD in the patients undergo-ing carotid endarterectomy.
