CAJ | 학술논문

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。
목적：탐색경뇨도전렬선전절수술（ TURP）술후인지장애（ POCD）적발생궤제。방법회고분석20례TURP술후출현POCD환자적림상자료（ A조），배대선취수술지속시간、병정、체질량、년령등균접근단미발생POCD적TURP술후환자20례작위대조조（ B조）。비교2조환자재술전1d（t1）、술중（수술개시30 min，t2）、술후6 h（t3）급술후6 d（t4）적전해질、공복혈당농도급혈장삼투압적차이。결과 A조환자t2혈납급혈개농도현저저우B조（P균＜0．05）；이t3혈납、개、미리자농도급혈장삼투압균현저저우B조（P균＜0．05），A조환자t3혈당농도현저고우B조（P＜0．05），기여각시간점각관찰지표균무명현차이。결론술중、술후조기체액내배경적문란여POCD적발생구유상관성，재술중、술후조기유지환자체액내배경은정，대방치술후POCD유중요의의。
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 .