Holinski Sebastian, Claus Benjamin, Haeger Nicole, Neumann Konrad, Uebelhack Ralf, Konertz Wolfgang
Department of Cardiovascular Surgery, Charité Hospital, Med ical University, Berlin, Germany.
Ann Thorac Cardiovasc Surg. 2013;19(4):273-8. doi: 10.5761/atcs.oa.12.01938. Epub 2012 Dec 14.
Reduction of cognitive function is a possible side effect after coronary artery surgery using cardiopulmonary bypass (CPB). We investigated the effect of roller versus centrifugal pumps for CPB on cognitive performance in patients undergoing coronary artery bypass grafting (CABG).
50 consecutive CABG patients operated with centrifugal pump were compared to 50 roller pump patients matched for age and duration of CPB. Six neuropsychological subtests from the Syndrom Kurz Test and the Alzheimer's Disease Assessment Scale were performed preoperatively and on the third postoperative day in a double blind fashion. To assess the overall cognitive function and the degree of cognitive decline across all tests after surgery we combined the six test-scores by principal component analysis.
Patients with a mean age of 63.9±8.4 years received a mean of 3.0±0.9 bypasses within an average of 80.6±20.7 mins on CPB. These parameters as well as the preoperative combined neurocognitive score were not significantly different between the groups. After the operation there was a significant deterioration of the combined neuropsychological score in both groups (centrifugal: preop 0.41±2.49 vs.postop -2.86±2.70, p <0.0005 and roller: preop -0.41±2.35 vs. postop -2.73±3.16, p <0.0005). However, the patients operated with a centrifugal pump had a significantly greater decline of overall cognitive function compared to the roller pump patients(3.3±1.7 vs. 2.3±2.7, p = 0.04).
Roller pumps have a less cerebro-damaging effect than centrifugal pumps since they lead to a smaller postoperative decline of neuropsychological abilities in coronary bypass patients.
使用体外循环（CPB）进行冠状动脉手术后，认知功能减退是一种可能的副作用。我们研究了CPB中滚压泵与离心泵对接受冠状动脉旁路移植术（CABG）患者认知表现的影响。
将50例连续使用离心泵进行CABG手术的患者与50例年龄和CPB持续时间相匹配的滚压泵患者进行比较。术前和术后第三天以双盲方式进行了来自综合征简短测试和阿尔茨海默病评估量表的六项神经心理学子测试。为了评估手术后所有测试中的整体认知功能和认知下降程度，我们通过主成分分析将六个测试分数进行了合并。
平均年龄为63.9±8.4岁的患者在平均80.6±20.7分钟的CPB时间内平均接受了3.0±0.9次搭桥手术。这些参数以及术前合并神经认知评分在两组之间无显著差异。手术后，两组的合并神经心理学评分均有显著恶化（离心泵组：术前0.41±2.49 vs.术后-2.86±2.70，p<0.0005；滚压泵组：术前-0.41±
