Shaw P J, Bates D, Cartlidge N E, Heaviside D, French J M, Julian D G, Shaw D A
Br Med J (Clin Res Ed). 1986 Jul 19;293(6540):165-7. doi: 10.1136/bmj.293.6540.165.
As part of a major prospective study of the neurological complications of coronary artery bypass graft surgery patients were reviewed over six months to determine the clinical course and functional impact of early postoperative complications. One hundred and ninety one out of 312 (61%) patients had developed early postoperative disorders. At six months 165 of the 191 patients with early neurological complications were reviewed. Of the 165, 85 still had detectable neurological signs, but these were often minor and of little functional importance. Only 10 patients had neurological disability at six months, and this was major in only four patients, all of whom had suffered major perioperative stroke. No patient with non-disabling neurological complications in hospital became functionally impaired on returning home. Neurological disorders are not a major cause of failure to return to work by six months after coronary artery bypass surgery. Of 139 patients who were of working age and had not returned to work by six months, only four were prevented by neurological injury related to surgery. The long term prognosis for early neurological disorders after coronary artery bypass surgery is usually favourable, except in those patients who have sustained major perioperative stroke.
作为一项关于冠状动脉搭桥手术神经并发症的大型前瞻性研究的一部分，对患者进行了为期六个月的复查，以确定术后早期并发症的临床病程及功能影响。312例患者中有191例（61%）出现了术后早期病症。在六个月时，对191例有早期神经并发症的患者中的165例进行了复查。在这165例患者中，85例仍有可检测到的神经体征，但这些体征通常较轻，功能影响不大。六个月时仅有10例患者存在神经功能障碍，其中只有4例严重，这4例均发生了严重的围手术期卒中。住院时无致残性神经并发症的患者回家后并未出现功能受损。神经病症并非冠状动脉搭桥手术后六个月未能恢复工作的主要原因。在139例达到工作年龄且六个月后仍未恢复工作的患者中，仅有4例是由于手术相关的神经损伤所致。冠状动脉搭桥手术后早期神经病症的长期预后通常良好，但发生严重围手术期卒中的患者除外。
