Grote C L, Shanahan P T, Salmon P, Meyer R G, Barrett C, Lansing A
Department of Psychology and Social Sciences, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL 60612.
J Thorac Cardiovasc Surg. 1992 Nov;104(5):1405-9.
Cardiopulmonary bypass frequently causes new postoperative neuropsychologic deficits. To assess whether these deficits could be predicted or limited, we monitored 29 patients receiving bypass intraoperatively with an on-line computerized electroencephalograph. We hypothesized that the 15 patients whose cerebral perfusion pressure was adjusted on the basis of this electroencephalographic data would have fewer postoperative deficits than the 14 patients whose pressure was monitored on the basis of systemic pressure. The results showed that new postoperative cognitive deficits in both groups were less prevalent than in previous studies, but there was not a significant difference in outcomes between the two groups. The intraoperative electroencephalographic records correlated with surgical, but not neuropsychologic, outcome. It is concluded that careful attention to intraoperative cerebral perfusion pressure may decrease the prevalence of postoperative neuropsychologic complications, but that the use of a computerized electroencephalograph does not necessarily contribute to an improved outcome.
体外循环常常会导致术后出现新的神经心理缺陷。为了评估这些缺陷是否能够被预测或限制，我们术中使用在线计算机化脑电图对29例接受体外循环的患者进行了监测。我们假设，根据该脑电图数据调整脑灌注压的15例患者，其术后缺陷会少于根据体循环压力进行监测的14例患者。结果显示，两组术后新出现的认知缺陷均比之前的研究更为少见，但两组之间的结果并无显著差异。术中脑电图记录与手术结果相关，但与神经心理结果无关。得出的结论是，密切关注术中脑灌注压可能会降低术后神经心理并发症的发生率，但使用计算机化脑电图不一定会带来更好的结果。
