经尿道前列腺电切术后认知障碍与体液内环境变化的相关性研究

摘要

Objective It is to approach the occurrence mechanism of postoperative cognitive dysfunction ( POCD ) after transurethral resection of prostate (TURP).Methods 20 patients with POCD after TURP (group A) were retrospectively col-lected , matched 20 patients with similar duration of surgery , course of disease , weights and ages who did not happened POCD after TURP as control group (group B).The electrolyte, fast blood glucose and plasma osmotic pressure were compared be-tween two groups at 1 day before surgery (t1), intraoperative (30 min after the surgery began, t2), 6 hours (t3) and 6 days ( t4 ) after the operation .Results The serum concentrations of Na +and Ca2+in group A were markedly lower than that in group B at t2 (P<0.05), both serum concentrations of Na +, Mg2+, Ca2+and plasma osmotic pressure in group A were markedly lower than group B except fast blood glucose in group A was markedly higher than group B at t3(P<0.05).Con-clusions The incidence of POCD may be related to serum environment imbalance during intraoperative or early postoperative period, it is important to maintain the balance of serum environment in prevent and cure POCD during intraoperative or early postoperative .%目的：探索经尿道前列腺电切手术（ TURP）术后认知障碍（ POCD）的发生机制。方法回顾分析20例TURP术后出现POCD患者的临床资料（ A组），配对选取手术持续时间、病程、体质量、年龄等均接近但未发生POCD的TURP术后患者20例作为对照组（ B组）。比较2组患者在术前1d（t1）、术中（手术开始30 min，t2）、术后6 h（t3）及术后6 d（t4）的电解质、空腹血糖浓度及血浆渗透压的差异。结果 A组患者t2血钠及血钙浓度显著低于B组（P均＜0．05）；而t3血钠、钙、镁离子浓度及血浆渗透压均显著低于B组（P均＜0．05），A组患者t3血糖浓度显著高于B组（P＜0．05），其余各时间点各观察指标均无明显差异。结论术中、术后早期体液内环境的紊乱与POCD的发生具有相关性，在术中、术后早期维持患者体液内环境稳定，对防治术后POCD有重要意义。