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目的分析老年脑外科手术采用自体输血与同种输血对患者围术期脑氧合代谢及认知功能的影响。方法选取南乐县人民医院2013年3月—2016年9月收治的64例老年脑外科手术患者,采用随机数字表法分为观察组(32例)和对照组(32例),对照组给予同种输血,观察组给予自体输血,比较两组术前、术后3d、术后7d脑氧合代谢指标(脑氧耗、脑氧摄取率、乳酸生成量)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)水平,并以蒙特利尔认知评估量表(Mo CA)评价两组认知功能。结果观察组术后3 d、7 d脑氧耗、乳酸低于对照组,脑氧摄取率高于对照组,差异具有统计学意义(P<0.05);观察组术后3d Mo CA评分与对照组相比,明显较高,差异具有统计学意义(P<0.05);观察组术后7d IL-6低于对照组,差异具有统计学意义(P<0.05);两组术后7d IL-10均明显升高,且观察组高于对照组,差异具有统计学意义(P<0.05)。结论与同种输血相比,自体输血可改善老年脑外科手术患者围术期脑氧合代谢情况和认知功能。
Objective To analyze the effects of autologous blood transfusion and blood transfusion on cerebral oxygenation metabolism and cognitive function in elderly patients undergoing cerebral surgery. Methods Sixty-four elderly patients with brain surgery admitted from March 2013 to September 2016 in Nanle County People’s Hospital were divided into observation group (32 cases) and control group (32 cases) by random number table method, and control group Blood transfusion and observation group were given autologous blood transfusion. Cerebral oxygenation (cerebral oxygen consumption, cerebral oxygen uptake rate, lactate production), interleukin-6 (IL) -6) and interleukin-10 (IL-10) were measured. The cognitive function of the two groups was evaluated using the Montreal Cognitive Assessment Scale (Mo CA). Results The brain oxygen consumption and lactate in the observation group at 3 and 7 days after operation were lower than those in the control group, and the uptake rate of cerebral oxygen was higher than that in the control group (P <0.05) (P <0.05). The level of IL-6 in the observation group was lower than that in the control group on the 7th day after operation, the difference was statistically significant (P <0.05). The levels of IL- 10 were significantly higher, and the observation group than the control group, the difference was statistically significant (P <0.05). Conclusions Autologous blood transfusion can improve perioperative cerebral oxygenation metabolism and cognitive function in elderly patients with brain surgery compared with those of the same kind of blood transfusion.