Division of Anesthesiology, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.
World J Pediatr. 2010 Aug;6(3):268-70. doi: 10.1007/s12519-010-0017-2. Epub 2010 Feb 1.
Congenital heart disease (CHD) may cause deleterious effects on cognitive function in children. This study aimed to evaluate the changes of the cognitive and academic functioning in children aged less than 4 years with serious CHD following cardiac surgery with extracorporeal circulation (ECC).
A total of 100 children, aged 0-4 years with cyanotic (35) and acyanotic (65) heart diseases who had undergone cardiac surgery with ECC, were subjected to neuropsychological and behavioral evaluation using the Gesell Developmental Schedule (GDS) before operation and at 1 week, and 1, 3 and 6 months after operation.
The GDS scores in the first postoperative week were significantly lower than those before operation, but the scores increased gradually (P<0.01). ECC affected the GDS scores after operation, with the cyanotic children being more significantly affected than the acyanotic children. The GDS scores were negatively correlated with the age at each time point. The GDS scores were significantly lower in the cyanotic children than in the acyanotic children at 1 and 3 months postoperatively (P<0.01), but there was no significant difference at 6 months (P<0.05).
After cardiac surgery with ECC, the younger the children who have cardiac surgery, the more significantly the GDS score increases. The ECC mainly affects the cognitive ability and academic performance in cyanotic children in one month postoperatively.
先天性心脏病（CHD）可能会对儿童的认知功能造成有害影响。本研究旨在评估体外循环（ECC）下心内直视手术后年龄小于 4 岁的严重 CHD 患儿认知和学业功能的变化。
共 100 例年龄 0-4 岁的紫绀型（35 例）和非紫绀型（65 例）心脏病患儿，均接受 ECC 下心内直视手术，采用 Gesell 发育量表（GDS）于术前及术后 1 周、1、3 和 6 个月进行神经心理和行为评估。
术后第 1 周 GDS 评分明显低于术前，但逐渐升高（P<0.01）。ECC 影响术后 GDS 评分，紫绀型患儿受影响较非紫绀型患儿更明显。GDS 评分与各时间点的年龄呈负相关。术后 1 和 3 个月，紫绀型患儿的 GDS 评分明显低于非紫绀型患儿（P<0.01），但 6 个月时无显著差异（P<0.05）。
ECC 下心内直视手术后，年龄越小的患儿 GDS 评分增加越明显。ECC 主要影响术后 1 个月紫绀型患儿的认知能力和学业表现。
