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常温体外循环:对冠状动脉旁路移植术后持续性术后神经功能障碍发生率的影响。

Normothermic cardiopulmonary bypass: effect on the incidence of persistent postoperative neurological dysfunction following coronary artery bypass graft surgery.

机构信息

Department of Anesthesiology, Kokura Memorial Hospital, 1-1 Kifune-machi, Kokurakita-ku, 802, Kitakyushu, Japan.

出版信息

J Anesth. 1997 Jun;11(2):117-20. doi: 10.1007/BF02480072.

Abstract

We retrospectively reviewed the records of 250 consecutive patients undergoing coronary artery bypass graft surgery (CABG) from January 1994 through January 1996 to determine the incidence of persistent postoperative neurological dysfunction after CABG and to compare normothermic and moderate hypothermic cardiopulmonary bypass (CPB). Normothermic CPB was used in 128 patients (36°-37°C) and hypothermic CPB (27°-28°C) in 122 patients. Postoperative neurological dysfunction included focal motor deficits, delayed recovery of consciousness (>24h) after surgery, and seizures within 1 week postoperatively. Persistent neurological dysfunction was diagnosed if complete resolution had not occurred within 10 days of surgery. The incidence of persistent postoperative neurological dysfunction was 4.1% in the hypothermic CPB group and 2.3% in the normothermic CPB group. There were no statistically significant differences between the two groups (P=NS). These results suggest that normothermic CPB did not increase the incidence of persistent postoperative neurological dysfunction compared to hypothermic CPB.

摘要

我们回顾性分析了 1994 年 1 月至 1996 年 1 月期间 250 例行冠状动脉旁路移植术(CABG)患者的病历,以确定 CABG 后持续性术后神经功能障碍的发生率,并比较常温与中度低温心肺转流(CPB)。128 例患者采用常温 CPB(36°-37°C),122 例患者采用低温 CPB(27°-28°C)。术后神经功能障碍包括局灶性运动缺陷、术后意识恢复延迟(>24 小时)和术后 1 周内发作。如果术后 10 天内未完全缓解,则诊断为持续性术后神经功能障碍。低温 CPB 组持续性术后神经功能障碍的发生率为 4.1%,常温 CPB 组为 2.3%。两组间无统计学差异(P=NS)。这些结果表明,与低温 CPB 相比,常温 CPB 并未增加持续性术后神经功能障碍的发生率。

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