Smith P L, Treasure T, Newman S P, Joseph P, Ell P J, Schneidau A, Harrison M J
Lancet. 1986 Apr 12;1(8485):823-5. doi: 10.1016/s0140-6736(86)90938-4.
55 patients undergoing coronary-artery bypass surgery (CABS) and a comparison group of 20 patients having thoracic or major vascular surgery were investigated preoperatively and 8 days and 8 weeks postoperatively for changes in neuropsychological status, psychiatric state, cerebral blood flow, and neurological signs, this last being assessed also at 24 h. Major persisting neurological changes were rare, but minor abnormalities were significantly more common after CABS than after thoracic or vascular surgery. Neuropsychological deficits were common at 8 days in both CABS and comparison groups, and in about a third of all patients persisted at 8 weeks. Cerebral blood flow was reduced at 8 days in some CABS patients, but this was not significant for the group. Pre-existing cerebrovascular disease was not predictive, but low perfusion pressure and long bypass time were associated with postoperative deficits.
对55例行冠状动脉搭桥手术（CABS）的患者以及20例行胸科或大血管手术的对照组患者进行了术前、术后8天和8周的调查，以了解神经心理状态、精神状态、脑血流量和神经体征的变化，最后一项在术后24小时也进行了评估。严重的持续性神经变化很少见，但CABS术后轻微异常比胸科或血管手术后明显更常见。CABS组和对照组在术后8天神经心理缺陷都很常见，约三分之一的患者在术后8周仍持续存在。部分CABS患者在术后8天脑血流量减少，但该组差异无统计学意义。既往存在的脑血管疾病不能预测术后情况，但低灌注压和长时间的搭桥时间与术后缺陷相关。
