【摘要】 目的 探索单肺通气（OLV）期间脑组织氧饱和度（S_cO₂）降低对胸外科术后早期认知功能减退的预测性和降低阈值。方法 本研究为前瞻性队列研究。根据OLV期间S_cO₂相对基础值降低的百分比（S_cO₂变异度）,将254例患者分为四组：变异度<10%（D1组）、10%≤变异度<15%（D2组）、15%≤变异度<20%（D3组）和变异度≥20%（D4组）。主要观察结果为术后早期认知功能减退。结果 S_cO₂降低增加术后早期认知功能减退的发生率。OLV期间的最低脑氧饱和度(S_cO_2-min)、S_cO₂降低绝对值（ΔS_cO₂）和S_cO₂变异度对术后早期认知功能减退有良好的预测能力，ROC曲线下面积分别为0.752、0.774和0.786（P<0.001）,最佳截断值为S_cO_2-min<58.1%（敏感度66.2%,特异度75.7%）,ΔS_cO₂>7.0%（敏感度77.9%,特异度68.4%）,S_cO₂变异度>10.5%（敏感度77.9%,特异度67.2%）。结论 S_cO_2-min<58.1%、ΔS_cO₂>7.0%和S_cO₂变异度>10.5%是术后早期认知功能减退的预警值，可用于指导临床管理。更多还原

【Abstract】 Objective To explore the predictive performance of cerebral oxygen desaturation during one-lung ventilation（OLV）for early postoperative cognitive decline and the warning desaturation thresholds in thoracic surgery.Methods A prospective cohort study was employed for the project.A total of 254 patients were divided into four different groups according to the degree of S_cO₂ variation during OLV:S_cO₂ variation<10%（Group D1）; 10≤ S_cO₂ variation<15%（Group D2）; 15≤ S_cO₂ variation<20%（Group D3）; S_cO₂ variation ≥20%（Group D4）.The main outcome was early postoperative cognitive decline.Results Cerebral oxygenation desaturation increased the incidence of early postoperative cognitive decline.The minimal cerebral oxygen saturation（S_cO₂）during OLV(S_cO_2-min),absolute S_cO₂ drop（ΔS_cO₂）and S_cO₂ variation showed good predictive performance on the occurrence of early postoperative cognitive decline with the areas under ROC curves of 0.752,0.774 and 0.786（P<0.001）,respectively.The optimal cutoff values were S_cO_2-min<58.1% with 66.2% sensitivity and 75.7% specificity, ΔS_cO₂>7.0% with 77.9% sensitivity and 68.4% specificity, S_cO₂ variation>10.5% with 77.9% sensitivity and 67.2% specificity.Conclusion S_cO_2-min<58.1%,ΔS_cO₂>7.0% and S_cO₂ variation>10.5% can be the warning thresholds for early postoperative cognitive decline, which may be used to guide clinical management.更多还原