摘要
目的分析高血压患者采取沙滩椅位肩关节镜手术对改善前脑部氧饱和度及手术后认知功能作用。方法选择2017年1月~2019年1月本院进行沙滩椅位肩关节镜手术治疗的60例患者作为研究对象,依据患者血压水平情况分成常规组和实验组,每组各30例。其中常规组患者血压水平均正常,实验组患者均伴有高血压疾病。观察两组手术中输液量、尿量及手术时间;比较两组各时期健侧上桡动脉MAP水平和SjvO2水平;比较两组手术前后MMSE得分。结果两组手术中输液量及手术时间比较,差异无统计学意义(P>0.05),实验组手术中尿量低于常规组,差异有统计学意义(P<0.05)。两组肩关节镜手术时MAP水平比较,差异无统计学意义(P>0.05),实验组麻醉平面固定后及沙滩椅体位摆放后MAP水平均高于常规组,差异有统计学意义(P<0.05)。两组麻醉平面固定后、肩关节镜手术时SjvO2水平比较,差异无统计学意义(P>0.05),实验组沙滩椅体位摆放后SjvO2水平低于常规组,差异有统计学意义(P<0.05)。两组手术前后MMSE得分比较,差异均无统计学意义(P>0.05)。结论在肩关节镜手术时采取沙滩椅体位会降低高血压患者血压及脑氧饱和度,但对患者认知功能无明显影响。
Objective To analyze the effect of shoulder arthroscopic surgery on beach chair position in the improvement of forebrain oxygen saturation and postoperative cognitive function.Methods From January 2017 to January 2019,a total of 60 patients who underwent shoulder arthroscopic surgery on beach chair position in our hospital were selected as the study subjects.According to the blood pressure level of patients,they were divided into conventional group and experimental group,with 30 cases in each group.Among them,the blood pressure of patients in the conventional group was normal,and patients in the experimental group were all complicated with hypertension.The intraoperative infusion volume and urine volume,and the duration of surgery were observed in two groups,the MAP level and SjvO2 level of the superior radial artery on the healthy side were compared between different periods in two groups;the MMSE scores before and after surgery were compared in each group.Results There was no statistically significant difference in the intraoperative infusion volume and duration of surgery between the two groups(P>0.05).The intraoperative urine volume in the experimental group was lower than that in the conventional group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in MAP levels during shoulder arthroscopic surgery between the two groups(P>0.05).After fixation of the anesthetic plane and placing of the beach chair position in the experimental group,the MAP level was higher than that in the conventional group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in SjvO2 levels between the two groups after fixation of the anesthetic plane and during shoulder arthroscopic surgery(P>0.05).After placing of the beach chair position in the experimental group,the SjvO2 level was lower than that in the conventional group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in MMSE score between the two groups before and after surgery(P>0.05).Conclusion Taking beach chair position during shoulder arthroscopic surgery can reduce blood pressure and cerebral oxygen saturation in the patients with hypertension,but it has no significant effect on patients'cognitive function.
作者
郑平武
蔡雨珂
彭文勇
ZHENG Pingwu;CAI Yuke;PENG Wenyong(Department of Anesthesiology,Affliated Jinhua Hospital,Zhejiang University School of Medicine,Jinhua321000,China)
出处
《中国现代医生》
2020年第27期125-128,共4页
China Modern Doctor
基金
浙江省医药卫生科技计划项目(2020KY345)。
关键词
认知功能
氧饱和度
高血压
肩关节镜
沙滩椅位
Cognitive function
Oxygen saturation
Hypertension
Shoulder arthroscopy
Beach chair position
