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目的:了解肺移植患者围手术期神经认知障碍（perioperative neurocognitive disorders, PND）的发生率，探究PND的危险因素及其模型预测效能。方法:选择2019年6月—2020年5月于无锡市人民医院行肺移植手术患者为研究对象，于术前1 d和术后第7天、1个月、3个月分别接受简易精神状态检查（Mini Mental Status Examination, MMSE）量表及蒙特利尔认知评估（Montreal Cognitive Assessment, MoCA）量表检测判定是否发生PND，根据是否发生PND分为非PND组和PND组。记录患者一般资料、围手术期情况[包括ASA分级、入室肺动脉压、供肺冷缺血时间、体外膜氧合器（extracorporeal membrane oxygenator, ECMO）使用、肺动脉阻断时间、麻醉时间、手术时间、术中出血量、术中尿量、术中总输液量、术中总输血量、去甲肾上腺素用量、术中Hb下降率等]、术后入ICU后ECMO转流时间、拔管时间、ICU滞留时间、术后前3 d乳酸值等情况。采用Logistic回归模型分析肺移植患者术后第7天发生神经认知障碍的独立危险因素，构建受试者工作特征（receiver operating characteristic, ROC）曲线检验相关模型对PND的预测效能。结果:共纳入101例患者，术后第7天PND发生率为32.7%（33/101），术后1个月PND发生率降至14.9%（15/101），术后3个月PND发生率为8.9%（9/101）。在单因素分析中，术后第7天PND组供肺冷缺血时间、ECMO的使用、术后ECMO转流时间、ICU滞留时间和术后第2天乳酸值高于非PND组；术后1个月时PND组术后ECMO转流时间高于非PND组；术后3个月时PND组ICU滞留时间高于非PND组。多因素Logistic回归分析显示，供肺冷缺血时间和ICU滞留时间是肺移植患者术后第7天发生PND的独立危险因素，术后第7天ROC曲线下面积（area under curve, AUC）为0.709（95%CI 0.603~0.815，n P<0.01），预测PND敏感度为45.5%，特异性为88.2%。n 结论:肺移植患者术后第7天、1个月、3个月PND发生率分别为32.7%、14.9%和8.9%，供肺冷缺血时间和ICU滞留时间是肺移植患者术后第7天发生PND的早期危险因素。“,”Objective:To investigate the incidence of perioperative neurocognitive disorders (PND) in patients after lung transplantation, and explore PND's risk factors and its model's predictive efficiency.Methods:Patients who underwent lung transplantation in Wuxi People's Hospital from June 2019 to May 2020 were enrolled. They were assessed by the Mini Mental Status Examination (MMSE) and Montreal Cognitive Assessment (MoCA) Scales one day before surgery and Day 7, one month and three months after operation. According to the presence of PND, they were divided into two groups: a non-PND group and a PND group. The following information was collected: general information; perioperative conditions including American Society of Anesthesiologists (ASA) classification, ventricular pulmonary artery pressure, cold lung ischemia time, the use of extracorporeal membrane oxygenator (ECMO), pulmonary artery occlusion time, anesthesia time, operation time, intraoperative blood loss, intraoperative urine volume, total intraoperative fluid infusion, total intraoperative blood transfusion, norepinephrine dosage and intraoperative hemoglobin (Hb) reduction rate; ECMO bypass time after entering intensive care unit (n ICU), extubation time, ICU retention time, and lactic acid value three days after surgery. Logistic regression model was used to analyze the independent risk factors of neurocognitive disorders in patients on Day 7 after lung transplantation. A receiver operating characteristic (ROC) curve was plotted to verify the predictive efficiency of the model for PND.n Results:A total of 101 patients were included, and the incidence of PND was 32.7% (33/101) on Day 7 after surgery, which then decreased to 14.9% (15/101) one month after surgery, and 8.9% (9/101) three months after surgery. According to the univariate analysis, increases were found in the PND group as to the cold ischemia time of the donor lung, the use of ECMO, postoperative ECMO bypass time, the length of ICU stay on Day 7 after surgery and lactic acid value on Day 2 after surgery, compared with the non-PND group. Furthermore, the PND group presented increased postoperative ECMO bypass time one month after operation as well as increased length of ICU stay three months after operation, compared with the non-PND group. According to multivariate logistic regression analysis, the cold ischemia time of the donor lung and the length of ICU stay were the independent risk factors for postoperative PND on Day 7 after lung transplantation. The area under curve (AUC) was 0.709 (95%CI 0.603-0.815, n P<0.01), with a sensitivity of 45.5% and a specificity of 88.2% for predicting PND.n Conclusions:The incidences of PND are 32.7%, 14.9% and 8.9% on Day 7, one month and three months after lung transplantation, respectively. The cold ischemia time of the donor lung and the length of ICU stay are the early risk factors for PND on Day 7 after lung transplantation.