Haider Zulfiqar, Jalal Anjum, Alamgir Asif Rashid, Rasheed Irfan
Zulfiqar Haider, FRCS. Department of Cardiac Surgery, Faisalabad Institute of Cardiology, Faisalabad, Pakistan.
Anjum Jalal FCPS-CS, FRCS-CTh. Department of Cardiac Surgery, Faisalabad Institute of Cardiology, Faisalabad, Pakistan.
Pak J Med Sci. 2018 Jan-Feb;34(1):5-9. doi: 10.12669/pjms.341.14114.
To review the incidence of stroke in patients undergoing CABG and the impact of a preventive strategy adopted at tertiary care unit of cardiac surgery.
The data of all patients who underwent isolated CABG (N= 722) from July 2016 to August 2017 at Faisalabad Institute of Cardiology was retrieved for this retrospective study. All operations were done on cardiopulmonary bypass and cold blood cardioplegia. Numeric data was summarized as Mean ± Standard Deviation while categoric variables were summarized into frequency and percentage.
Mean age of patients was 53.83±8.8 years. Mean Parsonnet and Logistic EuroScore were 4.3±3.2 and 3.3±0.9 respectively. Forty nine patients (6.78%) had significant carotid artery disease. Mean number of grafts was 2.8±0.82. Diabetes was present in 27.8% patients. Neurological complications were noticed in 14 patients (1.94%) who included 12 permanent paralyses. Further subgroup analysis revealed that 67 patients who were operated by single clamp technique remained free of neurological complications. This is clinically remarkable finding but due to small population size it is statistically non- significant.
The incidence of neurological complications can be reduced significantly by adopting the appropriate preventing measures. Use of Single Clamp technique may be the reasons of such a low incidence of stroke in this study.
回顾接受冠状动脉旁路移植术（CABG）患者的中风发生率以及心脏外科三级护理单位所采取预防策略的影响。
本回顾性研究检索了2016年7月至2017年8月在费萨拉巴德心脏病学研究所接受单纯CABG手术的所有患者（N = 722）的数据。所有手术均在体外循环和冷血心脏停搏下进行。数值数据总结为均值±标准差，分类变量总结为频率和百分比。
患者的平均年龄为53.83±8.8岁。平均Parsonnet评分和逻辑欧洲评分分别为4.3±3.2和3.3±0.9。49例患者（6.78%）患有严重颈动脉疾病。平均移植血管数量为2.8±0.82。27.8%的患者患有糖尿病。14例患者（1.94%）出现神经并发症，其中包括12例永久性瘫痪。进一步的亚组分析显示，采用单钳技术进行手术的67例患者未出现神经并发症。这是一个具有临床意义的发现，但由于样本量较小，在统计学上无显著意义。
采取适当的预防措施可显著降低神经并发症的发生率。本研究中中风发生率较低可能是由于使用了单钳技术。
