Ajtay Zénó, Kellényi Lóránd, Hejjel László, Solymos Andor, Németh Adám, Bártfai Imre, Kovács Norbert, Cziráki Attila, Papp Lajos
Heart Institute, Medical Faculty, University of Pécs, Pécs, Hungary.
Med Sci Monit. 2009 Sep;15(9):CR470-6.
Cognitive deficit related to open heart surgery came into the focus of interest according to professional and social expectations. The negative effects on quality of life and the large number of involved patients emphasize the need its investigation.
MATERIAL/METHODS: The bedside measurement of simple and choice reaction times (sRT and cRT) has the objectivity of cortical evoked potential analysis without the need for EEG instrumentation and laboratory. This is a functional assessment similar to neuropsychological tests, but requires a significantly shorter time and is less demanding for the patient.
Fifty patients who had undergone open heart surgery were investigated. Statistically significant positive correlation of sRT and cRT prolongation and perfusion time was found. At the same time there were no statistically significant changes in mean sRT and cRT values before (sRT: 208+/-54 s, cRT: 369+/-59 s) and after (sRT: 229+/-67 s, cRT: 392+/-105 s) the surgery, probably due to the inhomogeneous patient population. The weak correlation (coefficients: 0.1418-0.8484) for sRT and cRT changes as a function of perfusion time confirms the presence of other factors of postoperative brain damage.
The investigated bedside test is clinically feasible, simple, and can be completed within 30 minutes. Further studies are encouraged to compare this method with other tests in a larger, stratified cardiac surgery population.
根据专业和社会期望,与心脏直视手术相关的认知缺陷成为关注焦点。对生活质量的负面影响以及大量患者受影响,凸显了对此进行调查的必要性。
材料/方法:简单和选择反应时间(sRT和cRT)的床旁测量具有皮质诱发电位分析的客观性,无需脑电图仪器和实验室。这是一种类似于神经心理学测试的功能评估,但所需时间显著更短,对患者要求更低。
对50例接受心脏直视手术的患者进行了调查。发现sRT和cRT延长与灌注时间存在统计学上的显著正相关。同时,手术前后sRT和cRT的平均值(术前:sRT:208±54秒,cRT:369±59秒;术后:sRT:229±67秒,cRT:392±105秒)无统计学上的显著变化,可能是由于患者群体的异质性。sRT和cRT变化与灌注时间的弱相关性(系数:0.1418 - 0.8484)证实存在术后脑损伤的其他因素。
所研究的床旁测试在临床上可行、简单,且可在30分钟内完成。鼓励进一步研究在更大的、分层的心脏手术人群中将此方法与其他测试进行比较。