颈动脉内膜剥脱术局部脑氧饱和度与术后脑血管反应性、神经认知功能的关系探讨OA

[Objective]To explore the relationship between intraoperative local cerebral oxygen saturation and postoperative cerebral vascular reactivity and neurocognitive function in carotid endarterectomy.[Methods]A total of 141 patients who underwent carotid endarterectomy in Luoyang Central Hospital Affiliated to Zhengzhou University from February 2020 to September 2024 were selected for the study,and the intraoperative local cerebral oxygen saturation and postoperative cerebral vascular reactivity of the patients were detected,and the patients were divided into a cognitive normal group(n=97)and a cognitive impairment group(n=44)according to the Montreal Cognitive Assessment(MoCA)scale scores.The intraoperative local cerebral oxygen saturation,postoperative cerebral vascular reactivity,MoCA scale scores and general information were compared between the two groups.The relationship between intraoperative local cerebral oxygen saturation and postoperative cerebral vascular reactivity and neurocognitive function were analyzed according to the Pearson's method,and the relevant factors affecting cognitive function after carotid endarterectomy were analyzed by logistic regression.[Results]Forty-four cases showed cognitive dysfunction among 141 patients after carotid endarterectomy,and the incidence rate was 31.21%.The proportion of patients with age≥65 years and diabetes in the cognitive dysfunction group were higher(P＜0.05),and the intraoperative local cerebral oxygen saturation,postoperative cerebral vascular reactivity and MoCA scale score were lower(P＜0.05).Pearson correlation analysis showed that intraoperative local cerebral oxygen saturation was positively correlated with postoperative cerebral vascular reactivity and neurocognitive function(P＜0.05),and the postoperative cerebral vascular reactivity was also positively correlated with neurocognitive function(P＜0.05).Logistic regression analysis showed that age,diabetes,intraoperative local cerebral oxygen saturation and postoperative cerebrovascular reactivity were the influencing factors of cognitive dysfunction after carotid endarterectomy(P＜0.05).[Conclusion]There are correlations between intraoperative local cerebral oxygen saturation and postoperative cerebral vascular reactivity and neurocognitive function in carotid endarterectomy,and there is also a correlation between postoperative cerebral vascular reactivity and neurocognitive function,and the intraoperative local cerebral oxygen saturation and postoperative cerebral vascular reactivity are both influencing factors of cognitive dysfunction after carotid endarterectomy.