术中低血压与血压波动对老年患者术后认知功能的影响

目的 研究老年患者在非心脏手术过程中，血压变化对术后认知功能障碍（POCD）的影响。方法 选择2014年9月至2015年9月在安徽省立医院接受非心脏手术的74例老年患者，按照术中血压变化情况分为低血压组、血压波动组和正常血压组，分析3组患者麻醉时间、手术时间、术中血压情况等。术前、术后第1天、第3天采用简易精神状态量表（MMSE）对患者进行POCD评定。结果 3组患者麻醉时间、手术时间的差异无统计学意义（P>0.05）。血压波动组患者术后第1天MMSE评分显著低于术前，且显著低于正常血压组和低血压组术后第1天MMSE评分，差异有统计学意义（P<0.05），术后第3天MMSE评分结果基本恢复术前水平。结论 术中血压波动与POCD的发生存在一定联系，而术中低血压与POCD无关。

Impact of intraoperative blood pressure fluctuation and hypotension on early postoperative cognitive dysfunction after undergoing non-cardiac surgery in elderly patients

Objective To study Impact of intraoperative blood pressure fluctuations and hypotension on early postoperative cognitive dysfunction after undergoing non-cardiac surgery in elderly patients.Methods A total of 74 elderly patients who received surgery were divided into hypotension group,blood pressure fluctuation group and normal group.The MMSE(mini-mental state examination) was used to assess cognitive function preoperatively and on the first day and the third day after operation.Results There were no significant differences among there groups in age, sex, height, time of surgery, time of anaesthesia, scores of MMSE before surgery and on the third day after operation. Significant differences were found among there groups in scores of MMSE on the first day after surgery, the scores were markedly lower in blood pressure fluctuation group(19.88±2.76) than normal group(26.55±1.15)(P=0.02) and hypotension group(27.00±1.19) (P=0.04). Conclusion Intraoperative blood pressure fluctuation is relevant closely with early postoperative cognitive function in elderly patients.