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[使用脑电图监测在体外循环期间早期检测中枢神经系统功能障碍]

[Early detection of central nervous system dysfunction during cardiopulmonary bypass using EEG monitoring].

作者信息

Suzuki I, Kanabuchi K, Koide S, Kawada S, Shohtsu A

机构信息

First Department of Surgery, Tokai University School of Medicine, Kanagawa, Japan.

出版信息

Nihon Geka Gakkai Zasshi. 1988 Jul;89(7):1083-92.

PMID:3221829
Abstract

The EEG was monitored in fifty-four patients during and after various surgeries requiring cardiopulmonary bypass (CPB) to assist in the early detection of central nervous system dysfunction (CNSD). Bilateral frontopolar EEG signals were processed with a 2-channel, real-time Fast-Fourier-Transformer (FFT) analyser and Compressed Spectral Arrays (CSA) were obtained. The fifty-four patients were divided into 3 groups based upon clinical outcome; Group 1: patients without CNSD (83%); Group 2: patients with delayed recovery from anesthesia but without CNSD (4%); and Group 3: patients with apparent postoperative CNSD (13%). There was no difference in the CSA among these groups prior to rewarming, but after the rewarming phase, two distinct sets emerged. Groups 1 and 2 showed a shift of the CSA predominant peak from a low frequency to a higher frequency. On the other hand, Group 3 patients demonstrated either stable predominant peaks in the lower frequencies or gradual flattening of the CSA. We conclude that the intra-operative EEG monitoring is a useful tool for the early detection of CNSD during and after CPB.

摘要

在54例接受各种需要体外循环(CPB)的手术的患者术中及术后监测脑电图(EEG),以协助早期发现中枢神经系统功能障碍(CNSD)。使用双通道实时快速傅里叶变换(FFT)分析仪处理双侧额极EEG信号,并获得压缩谱阵图(CSA)。根据临床结果将54例患者分为3组;第1组:无CNSD的患者(83%);第2组:麻醉恢复延迟但无CNSD的患者(4%);第3组:术后明显出现CNSD的患者(13%)。复温前这些组之间的CSA没有差异,但在复温阶段后,出现了两组不同的情况。第1组和第2组显示CSA主峰从低频向高频转移。另一方面,第3组患者要么在较低频率下有稳定的主峰,要么CSA逐渐变平。我们得出结论,术中EEG监测是CPB期间及术后早期检测CNSD的有用工具。

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