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单肺通气术后认知功能障碍和脑氧饱和度关系的研究(英文).docx

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单肺通气术后认知功能障碍和脑氧饱和度关系的研究(英文) Introduction Single-lungventilation(SLV)isanimportanttechniqueinthoracicsurgeries,whichventilatesonlyonelungwhilecollapsingtheothertoprovideaclearviewofthesurgicalfield(1).DespitethebenefitsofSLVinthoracicsurgeries,ithasbeenassociatedwithvariouscomplications,includingdecreasedcognitivefunction(2).SeveralstudieshavesuggestedthattheremaybeacorrelationbetweenSLVandcognitiveimpairment.Furthermore,ithasbeenfoundthatcerebraloxygensaturation(rSO2)mayexacerbatepostoperativecognitivedysfunction(POCD)inpatientsundergoingSLV(3).Therefore,thisstudyaimedtoinvestigatetherelationshipbetweenSLVandcognitivefunctionimpairment,aswellastheroleofrSO2levelsinthedevelopmentofPOCD. Methods Thestudywasconductedon100patientswhounderwentSLVduringthoracicsurgeries.Thesepatientswererandomizedintotwogroups:theinterventiongroup(n=50)andthecontrolgroup(n=50).TheinterventiongroupreceivedmonitoringofrSO2levelsduringtheSLVprocedure,whilethecontrolgroupdidnot.CognitivefunctionassessmentswereperformedonpatientsbeforeandaftersurgeryusingtheMini-MentalStateExamination(MMSE)andMontrealCognitiveAssessment(MoCA)tools. Results Theresultsofthestudyrevealedthatpatientsintheinterventiongrouphadasignificantlyhigherincidenceofcognitivedysfunctioncomparedtothecontrolgroup.Furthermore,patientswhohadalowerrSO2levelduringSLVhadahigherincidenceofPOCDthanthosewhohadahigherrSO2level.TheMMSEandMoCAscoresweresignificantlylowerinpatientswhohadalowerrSO2levelduringSLVcomparedtothosewhohadahigherrSO2level. Discussion ThisstudysuggeststhatSLVmaybeariskfactorforcognitivedysfunction,andrSO2levelsmayplayasignificantroleinthedevelopmentofPOCD.ThefindingsofthisstudyareconsistentwiththeresultsofpreviousstudiesthathaveshownacorrelationbetweenSLVandcognitiveimpairment(4).TheunderlyingmechanismbehindthiscorrelationmaybeattributedtothereductionincerebralbloodflowandoxygendeliverytothebrainduringSLV.TherSO2levelsmayserveasanindirectindicatorofcerebralperfusionandoxygendelivery.Therefore,monitoringrSO2levelsdu