探讨脑氧饱和度（rScO₂）监测在后腹腔镜下嗜铬细胞瘤切除术中脑保护的意义。

回顾性收集2018年3月至2019年9月择期行后腹腔镜下嗜铬细胞瘤切除术患者共55例的临床资料，A组34例，B组21例，A组患者术中监测rScO₂，B组不监测rScO₂，分别记录两组患者：T₁（切除瘤体前）、T₂（切除瘤体中）、T₃（切除瘤体后）、T₄（关气腹前5 min）时刻，中心静脉压（CVP），A组患者的rScO₂。检测并记录T₁～T₄即刻的血气PaCO₂、PaO₂、PH、Hb、血乳酸浓度（Lac）、血糖等数据。分别于术前1 d与术后7 d评估蒙特利尔认知评价量表（MoCA），入室即刻与术后3 d检测血浆S-100β蛋白浓度。

两组患者CVP与T_1、2、4时刻比较，T₃时刻明显降低，差异有统计学意义（P<0.05）；rScO₂与T_1、4时刻比较，T₂时刻明显升高，与T_1、4时刻比较，T₃时刻明显降低，差异有统计学意义（P<0.05）；Lac与T_1、2、4时刻比较，T₃时刻明显增高，差异有统计学意义（P<0.05）；组间比较差异均无统计学意义（P均>0.05），T₁～T₄组间及组内PaCO₂、PaO₂、pH、Hb比较，差异均无统计学意义（P>0.05）。A组患者术后3 d S-100β蛋白浓度低于B组患者，差异有统计学意义（P<0.05），两组患者S-100β蛋白与入室即刻比较，术后3 d均明显升高，差异有统计学意义（P均<0.05）；两组患者MoCA评分与术前1 d比较，术后7 d均明显降低，差异有统计学意义（P均<0.05）；A组患者术后认知功能障碍（POCD）发生率低于B组患者，差异有统计学意义（P<0.05）。

在后腹腔镜嗜铬细胞瘤切除术中监测rScO₂并及时处理脑氧供/需失衡，具有脑保护、降低POCD发生率的作用。

To investigate the significance of cerebral oxygen saturation monitoring in retrolaparoscopic pheochromocytoma resection.

The clinical data of a total of 55 patients undergoing retroperitoneal laparoscopic pheochromocytoma resection from March 2018 to September 2019 were retrospectively collected. They were divided into experimental group (group A) of 34 patients and control group (group B) of 21 patients. rScO₂ was monitored during operation in group A; rScO₂ was not monitored in group B. central venous pressure (CVP) and rScO₂ in group A were respectively recorded at T₁ (before tumor resection), T₂ (in tumor resection), T₃ (after tumor resection), T₄ (5 min before pneumoperitoneum resection). The immediate blood gas PH, PaCO₂, Hb, Lac, blood glucose and other data of T₁-T₄ were detected and recorded. Montreal Cognitive Assessment (MoCA) was respectively performed at 1 day before surgery and 7 days after surgery. S-100β protein was respectively detected after entering the operating room and 3 days after operation.

Compared with T_{1, 2, 4}, CVP decreased significantly at T₃ in the two groups (P<0.05). Compared with T₁ and T₄, rScO₂ increased significantly at T₂ and decreased significantly at T₃ in group A (P<0.05). Compared with T_{1, 2, 4}, Lac increased significantly at T₃ (P<0.05). PaCO₂, PaO₂, PH and Hb were not significantly different between the two groups (P>0.05) at T₁-T₄. The level of s-100β protein in group A was lower than that in group B at 3 days after operation (P<0.05). Compared with that immediately after entering the operating room, the level of S-100β protein increased significantly at 3 days after operation in the two groups (P<0.05). Compared with 1 day before operation, MoCA significantly decreased on 7 days after operation in two groups (P<0.05). The incidence of POCD in group A was lower than that in group B (P<0.05).

Monitoring rScO₂ and dealing with cerebral oxygen supply-demand imbalance in retrolaparoscopic pheochromocytoma resection can protect the brain and reduce the incidence of POCD.