中国人群非冠状动脉搭桥手术后早期认知功能障碍的危险因素
Risk factors for early postoperative cognitive dysfunction after non-coronary bypass surgery in Chinese population.
作者信息
Xu Tao, Bo Lulong, Wang Jiafeng, Zhao Zhenzhen, Xu Zhiyun, Deng Xiaoming, Zhu Wenzhong
机构信息
Department of Anesthesiology and Intensive Care Medicine, Changhai hospital, Second Military Medical University, Shanghai, China.
出版信息
J Cardiothorac Surg. 2013 Nov 1;8:204. doi: 10.1186/1749-8090-8-204.
Abstract
BACKGROUND
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.
METHODS
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.
RESULTS
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.
CONCLUSION
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.
摘要
背景
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。
方法
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。
结果
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。
结论
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。
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