Weissrock S, Levy F, Balabaud V, Thiranos J-C, Dupeyron J-P, Steib A
Département d'anesthésiologie, hôpital civil, 1, route de l'Hôpital, 67091 Strasbourg cedex, France.
Ann Fr Anesth Reanim. 2005 Oct;24(10):1255-61. doi: 10.1016/j.annfar.2005.05.022. Epub 2005 Jul 12.
Cognitive defects are frequently described after cardiac surgery. They occur in 30 to 79% cases. They might be related to the use of a cardiopulmonary bypass (CPB). They are poorly evaluated in clinical practice.
To evaluate the usefulness of the Mini Mental State Examination (MMSE) to screen patients scheduled for cardiac surgery.
Prospective, open study.
100 consecutive patients undergoing coronary artery bypass or valvular replacement under CPB were enrolled in the study. The MMSE was performed the day before surgery and five days later. Patients exhiting a postoperative defect> or =4 points were compared to those without changes or with improved results.
73 patients completed both tests. The mean score decreased postoperatively in 12 patients (15%). They were older (70+/-8 years), had longer CBP durations (128+/-50 min) and the lowest temperatures (30 degrees C+/-3) compared to the other patients. At the opposite, five patients (9%) improved their scores.
These results entourage to carry out a more strict follow-up for the oldest patients in cardiac surgery. The MMSE could be systematically integrated to the pre and postoperative screening. The detection of cognitive dysfunction should lead to address the patient to a geriatrician for a prolonged follow-up.
心脏手术后经常会出现认知缺陷。其发生率为30%至79%。可能与体外循环（CPB）的使用有关。在临床实践中对其评估不足。
评估简易精神状态检查表（MMSE）对计划进行心脏手术患者的筛查作用。
前瞻性、开放性研究。
100例连续接受CPB下冠状动脉搭桥或瓣膜置换手术的患者纳入研究。术前一天和术后五天进行MMSE检查。将术后出现缺陷≥4分的患者与无变化或结果改善的患者进行比较。
73例患者完成了两项检查。12例患者（15%）术后平均得分下降。与其他患者相比，他们年龄更大（70±8岁），CPB持续时间更长（128±50分钟），体温最低（30℃±3）。相反，5例患者（9%）得分提高。
这些结果促使对心脏手术中年龄较大的患者进行更严格的随访。MMSE可系统地纳入术前和术后筛查。认知功能障碍的检测应促使患者去找老年病专家进行长期随访。
