Neurosciences Research Center, Imam Reza Hospital.
Neuropsychiatr Dis Treat. 2010 Nov 19;6:775-8. doi: 10.2147/NDT.S14348.
Coronary artery bypass graft (CABG) surgery is one of the most commonly performed surgical procedures worldwide, and it may be accompanied by postoperative neurocognitive impairment. Although this complication has been attributed to the use of cardiopulmonary bypass, it is still a matter of debate whether the switch from on-pump to off-pump technique affects the cognitive function.
The aim of this study was to compare the impact of the on-pump and off-pump techniques on neurocognitive impairment in low-risk CABG surgery groups.
In a descriptive and analytic study, 201 CABG patients with left-ventricular ejection fraction >30%, and without cardiac arrhythmia were enrolled. Before the elective operation, all patients underwent neurological examination and neurocognitive test, Mini-Mental State Examination (MMSE). Two months following the operation, both on- and off-pump, the patients were re-examined by MMSE to detect any neurocognitive impairment.
Out of 154 patients included in the study, 95 (61.6%) and 59 (38.3%) patients were in off-pump and on-pump groups, respectively. Mean age of the patients was 57.17 ± 9.82 years. A 2-month postoperative neurocognitive impairment was detected among 17 patients of on-pump group (28.8%) and in 28 cases of off-pump group (29.4%) (P = 0.54). The mean postoperative MMSE scores were not comparable between groups (25.01 ± 4.49 in off-pump group versus 23.73 ± 4.88 in on-pump group, P = 0.09).
The present study revealed that in low-risk patients undergoing CABG surgery, either the techniques of on-pump or off-pump did not differ regarding the neurocognitive outcome 2 months after the procedure.
冠状动脉旁路移植术（CABG）是全球最常见的手术之一，术后可能会出现神经认知障碍。尽管这种并发症归因于体外循环的使用，但体外循环与非体外循环技术的转换是否会影响认知功能仍存在争议。
本研究旨在比较低危 CABG 手术组中体外循环和非体外循环技术对神经认知障碍的影响。
在一项描述性和分析性研究中，纳入了 201 名左心室射血分数>30%且无心律失常的 CABG 患者。在选择性手术前，所有患者均接受了神经科检查和神经认知测试，包括简易精神状态检查（MMSE）。在体外循环和非体外循环手术后 2 个月，对所有患者进行 MMSE 复查，以检测是否存在神经认知障碍。
在纳入的 154 名患者中，95 名（61.6%）和 59 名（38.3%）患者分别在非体外循环和体外循环组中。患者的平均年龄为 57.17 ± 9.82 岁。体外循环组有 17 例（28.8%）和非体外循环组有 28 例（29.4%）患者术后 2 个月出现神经认知障碍（P = 0.54）。两组术后 MMSE 评分无显著差异（非体外循环组为 25.01 ± 4.49，体外循环组为 23.73 ± 4.88，P = 0.09）。
本研究表明，在接受 CABG 手术的低危患者中，体外循环与非体外循环技术在术后 2 个月时对神经认知结局无差异。
