Xu Tao, Bo Lulong, Wang Jiafeng, Zhao Zhenzhen, Xu Zhiyun, Deng Xiaoming, Zhu Wenzhong
Department of Anesthesiology and Intensive Care Medicine, Changhai hospital, Second Military Medical University, Shanghai, China.
J Cardiothorac Surg. 2013 Nov 1;8:204. doi: 10.1186/1749-8090-8-204.
The present study was performed to investigate the incidence of early postoperative cognitive dysfunction (POCD) after non-coronary bypass surgery and the potential risk factors in Chinese population.
We performed a prospective study in a teaching tertiary hospital from May 2012 to August 2012. One hundred and seventy-six adult patients undergoing non-coronary bypass surgery were recruited. Mini-Mental State Examination (MMSE) score was evaluated before and 3 to 5 days after surgery. Patients with a MMSE score reduction of 2 was diagnosed with POCD.
The general incidence of POCD was 33.0%, with no significant difference between the types of surgeries. In the univariate analysis, POCD associated factors included age, duration of surgery, anesthesia, cardiopulmonary bypass (CPB), cross-clamp and rewarming, and sevoflurane concentration. However, only age, cross-clamp duration and sevoflurane concentration were demonstrated to be independent risk factors for POCD.
Incidence of early POCD after non-coronary bypass surgery was relatively high in Chinese population. Advanced age, longer aortic cross-clamp duration and lower sevoflurane concentration was associated with a higher incidence of POCD.
本研究旨在调查非冠状动脉搭桥手术后早期认知功能障碍（POCD）的发生率及中国人群中的潜在危险因素。
2012年5月至2012年8月，我们在一家教学型三级医院进行了一项前瞻性研究。招募了176例接受非冠状动脉搭桥手术的成年患者。在手术前及术后3至5天评估简易精神状态检查表（MMSE）评分。MMSE评分降低2分的患者被诊断为POCD。
POCD的总体发生率为33.0%，不同手术类型之间无显著差异。在单因素分析中，与POCD相关的因素包括年龄、手术持续时间、麻醉、体外循环（CPB）、主动脉阻断和复温以及七氟醚浓度。然而，只有年龄、主动脉阻断时间和七氟醚浓度被证明是POCD的独立危险因素。
在中国人群中，非冠状动脉搭桥手术后早期POCD的发生率相对较高。高龄、较长的主动脉阻断时间和较低的七氟醚浓度与较高的POCD发生率相关。
