Abstract: AIM: To explore the effect of intestinal flora disturbance on postoperative cognitive dysfunction in patients with inhalation anesthesia by using propensity score matching method.  METHODS: Patients received inhalation anesthesia of patients between January 2018 and December 2021 in our hospital were included in the study. 91 cases of postoperative cognitive dysfunction patients as cognitive impairment group, 85 cases of postoperative cognitive dysfunction patients as control group. Propensity score matching method was used to compare the clinical data and bacterial DNA, which was extracted from the stool samples of the two groups before surgery. And 16S rRNA sequencing was performed to analyze the differences of intestinal flora between the two groups. RESULTS: A total of 20 pairs of patients were successfully matched between the two groups. There was no significant difference in age, gender and other general information between the two groups (P>0.05). PCoA analysis showed that although there was some overlap in the PCoA plot of stool samples from the two groups, the PCoA scatter plot showed significant differences between the two groups. LEfse multistage species difference discriminant analysis showed that at the genus level, the abundance of 6 bacteria genera was higher in the cognitive impairment group. The intestinal bacillus genus, MAO spirillum, thick wall bacteria door, clostridium, neisseria bacterium, neisseria bacteria genera abundance increased in the cognitive impairment group, majorly the klebsiella bacillus clostridium, platts bacteria and enterobacteriaceae, mesh, wool spirillum, addicted to bile bacteria genera, door deformation, clostridium, enterobacteriaceae bacteria enriched, etc. CONCLUSION: Cognitive dysfunction in patients with inhalation anesthesia is related to intestinal flora disorder, which is mainly manifested by the enrichment of Bacteria such as Leiborella and Prevotella.

Key words: intestinal flora, inhalation anesthesia, cognitive dysfunction, correlation analysis, tendency score