论文部分内容阅读
目的:探讨老年患者术中局部脑氧饱和度（rSctOn 2）变化幅度与患者术前基础疾病及术中因素的相关性。n 方法:回顾性分析美国耶鲁纽黑文医院2016年10月至2017年2月进行择期腹腔镜子宫切除术老年患者39例，记录患者基本情况、既往病史、术中指标和rSctOn 2指标（基线值、最大值、最小值、最大值-基线值、基线值-最小值）。采用Pearson相关分析rSctOn 2各项指标与术前、术中因素的相关性，采用独立样本n t检验比较高血压组与非高血压组、糖尿病组与非糖尿病组之间rSctOn 2各项指标的差异；以有无糖尿病作为分层因素，对年龄、体质指数（BMI）、高血压与rSctOn 2各项指标相关性进行多因素分析。n 结果:患者年龄（67.6±5.6）岁，左侧额叶rSctOn 2基线值为（71.2±3.9）%，右侧为（70.8±4.1）%。高血压组左、右侧rSctOn 2最大值-基线值分别为（12.9±4.5）%、（12.8±4.4）%，小于非高血压组的（16.3±4.2）%和（16.2±4.9）%（n t=2.329、2.266，均n P<0.05）；高血压组的右侧基线值-最小值为（5.3±3.7）%，显著大于非高血压组的（2.7±4.2）%（n t=-2.061，n P<0.05）。糖尿病组左侧rSctOn 2最小值为（64.4±4.2）%，左、右侧最大值分别为（81.7±4.0）%、（81.9±4.5）%，均低于非糖尿病组的（68.4±4.1）%、（86.7±4.2）%、（86.0±3.7）%（n t=2.623、3.297、2.850，均n P<0.05）。多因素分析结果显示糖尿病组年龄（n t=2.866，n P<0.05）、高血压病（n t=-4.530，n P<0.01）对左侧最大值-基线值具有影响；高血压对右侧最大值-基线值具有影响（n t=-4.629，n P<0.01）。n 结论:术前合并糖尿病、高血压对腹腔镜子宫切除术老年患者术中rSctOn 2的变化具有显著影响。n “,”Objective:To explore the factors that affect the fluctuation of intraoperative regional cerebral oxygen saturation (rSctOn 2) in elderly patients undergoing laparoscopic hysterectomy.n Methods:A retrospective analysis of 39 elderly patients undergoing elective laparoscopic hysterectomy in Yale New Haven Hospital from October 2016 to February 2017 was performed. Factors including patients′ demographic data, past medical history, intraoperative monitoring index and rSctOn 2 index (baseline, maximum, minimum, maximum-baseline, baseline-minimum) were recorded. Pearson correlation analysis was used to analyze the correlation between rSctOn 2 indexes and preoperative and intraoperative factors. Independent sample n t-test was used to compare the differences of rSctOn 2 indexes between hypertension group and the group without hypertension, as well as diabetes group and the group without diabetes. Taking diabetes as the stratification factor, the relationship between rSctOn 2and factors including age, body mass index, hypertension were analyzed using multivariate analysis.n Results:The age of the patients was (67.6±5.6) years old. The baseline value of rSctOn 2 was (71.2±3.9)% in the left frontal lobe and (70.8±4.1)% in the right frontal lobe. Results from univariate analysis showed that the left and right maximum-baseline value of rSctOn 2 were (12.9±4.5)% and (12.8±4.4)%, which were significantly lower than (16.3±4.2)% and (16.2±4.9)% in the group without hypertension (n t=2.329, 2.266, all n P<0.05). The right baseline-minimum in the group with hypertension was (5.3±3.7)%, which was significantly higher than (2.7±4.2)% in the group without hypertension (n t=-2.061, n P<0.05). The left minimum value of rSctOn 2 in diabetic group was (64.4±4.2)%, and the maximum value of rSctOn 2on the left and right sides were (81.7±4.0)% and (81.9±4.5)%, which were lower than (68.4±4.1)%, (86.7±4.2)% and (86.0±3.7)% in the group without diabetes (n t=2.623, 3.297, 2.850, all n P<0.05). The results of multivariate analysis showed the influence of age (n t=2.866, n P<0.05) and hypertension on left maximum-baseline (n t=-4.530, n P<0.01) was statistically significant. The influence of hypertension on right maximum-baseline was statistically significant (n t=-4.629,n P<0.01).n Conclusion:Preoperative diabetes and hypertension are factors significantly affecting the intraoperative rSctOn 2 of elderly patients with laparoscopic hysterectomy.n