Han Qing-qi, Xu Zhi-yun, Zhang Bao-ren, Xu Ji-bin, Han Lin, He Bin, Zhao Tie-jun
Department of Cardiothoracic Surgery, Changhai Hospital, Second Military Medical University, Shanghai 200433, China.
Zhonghua Wai Ke Za Zhi. 2007 Mar 15;45(6):419-22.
To assess impact of different brain protection techniques upon postoperative temporary neurological dysfunction in aortic surgery with the aid of deep hypothermic circulatory arrest.
From January 2003 to December 2005, 78 patients who met the inclusion criteria entered the present cohort, 43 of whom were under the aid of deep hypothermic circulatory arrest plus retrograde cerebral perfusion (RCP group) and the other 35 under deep hypothermic circulatory arrest plus selective antegrade cerebral perfusion (SCP group). The present and grades of postoperative temporary neurological dysfunction were assessed by independent observers with the same criterion. The impact of duration of deep hypothermic circulatory arrest upon the postoperative temporary neurological dysfunction was also evaluated.
The incidence of postoperative temporary neurological dysfunction was significantly higher in the RCP group than in the SCP group (15, 34.9% vs. 4, 11.4%, P<0.05). And long duration of deep hypothermic circulatory arrest (more than 50 min) has a negative impact on the postoperative temporary neurological dysfunction rate.
Applying selective antegrade cerebral perfusion as the brain protection technique and shortening the duration of deep hypothermic circulatory arrest can reduce the incidence of temporary neurological dysfunction and preserve cerebral function more effectively.
借助深低温停循环评估不同脑保护技术对主动脉手术术后短暂性神经功能障碍的影响。
2003年1月至2005年12月，78例符合纳入标准的患者进入本队列，其中43例采用深低温停循环加逆行脑灌注（RCP组），另外35例采用深低温停循环加选择性顺行脑灌注（SCP组）。由独立观察者采用相同标准评估术后短暂性神经功能障碍的发生情况及分级。还评估了深低温停循环时间对术后短暂性神经功能障碍的影响。
RCP组术后短暂性神经功能障碍的发生率显著高于SCP组（15例，34.9%对4例，11.4%，P<0.05）。深低温停循环时间过长（超过50分钟）对术后短暂性神经功能障碍发生率有负面影响。
采用选择性顺行脑灌注作为脑保护技术并缩短深低温停循环时间可降低短暂性神经功能障碍的发生率，并更有效地保护脑功能。
