不同手术类型、手术方式以及人群的术后新发心房颤动(post-operative atrial fibrillation, POAF)发病率存在较大差异。非心脏胸外科手术后POAF在围术期较为常见,可能与炎症反应、氧化应激以及交感神经激活等多种原因有关。虽然多数房颤表现为无症状或是一过性,但越来越多研究表明POAF会增加住院时长和费用及远期心血管不良事件的发生率。因此,识别POAF发生的危险因素并监测其预测指标,能够更有针对性地对其进行早期预防、诊断及治疗。The incidence of postoperative new-onset atrial fibrillation (POAF) varies widely depending on the type of surgery, surgical procedure, and population. POAF is more common in the perioperative period after noncardiac thoracic surgery and may be related to a variety of causes, including inflammatory response, oxidative stress, and sympathetic activation. Although most atrial fibrillation is asymptomatic or transient, several studies have shown that POAF increases the length and cost of hospitalization and the incidence of long-term adverse cardiovascular events. Therefore, identifying the risk factors for POAF and monitoring its predictive indicators will enable more targeted early prevention, diagnosis, and treatment of POAF.
目的探讨机器人辅助泌尿外科手术老年病人术后近远期认知功能的发展轨迹。方法收集年龄≥65岁行机器人辅助泌尿外科手术病人的基本资料,使用MMSE、认知状态电话访谈修订版(Telephone Interview for Cognitive Status-Modified,TICS-m)量表进行神经认知功能评估,明确该类手术病人术后近远期认知功能的发展轨迹。结果老年病人机器人辅助泌尿外科手术后1、3、6个月认知功能障碍的发生率分别为26.7%、19.9%、14.3%,严重认知功能障碍的发生率为6.2%、4.7%、4.4%。此外,术前认知功能障碍组和认知功能正常组手术后3个月的TICS-m评分分别为(33.47±3.81)分和(35.12±4.12)分,2组间差异具有统计学意义(P=0.009)。与术后1个月认知功能正常的人群相比,术后1个月认知障碍的病人术后3个月和6个月发生认知功能障碍的概率显著增加。结论机器人辅助泌尿外科手术老年病人术前认知功能障碍与术后3个月认知功能障碍相关,术后1个月发生认知障碍对术后远期认知功能障碍的发生具有预警作用。
