Ferry P C
Am J Dis Child. 1987 Mar;141(3):309-12. doi: 10.1001/archpedi.1987.04460030087032.
Major advances in surgical and cardiopulmonary bypass technology have occurred in the past 30 years. Total correction of previously inoperable congenital cardiac defects is being performed with increasing frequency and in children at progressively younger ages. While the majority of children undergoing cardiac surgery survive without incident, increasing concern is being raised about neurologic sequelae seen in some survivors. Complications such as embolization, hypoxia, inadequate cerebral perfusion, and biochemical disturbances may all lead to brain damage following cardiac surgery. Acute postoperative neurologic problems include seizures, impaired levels of consciousness, focal motor deficits, and movement disorders. Long-term sequelae include language and learning disorders, mental retardation, seizures, and cerebral palsy. Intraoperative cerebral monitoring techniques are as yet imperfect, but their use in combination with meticulous intraoperative and postoperative care currently provides the best means of reducing neurologic morbidity. Future studies should explore other methods of preserving neurologic integrity in children undergoing open heart surgery.
在过去30年里，外科手术和体外循环技术取得了重大进展。以前无法手术治疗的先天性心脏缺陷现在越来越多地得到完全矫正，而且接受手术的儿童年龄也越来越小。虽然大多数接受心脏手术的儿童都能顺利存活，但人们越来越关注一些幸存者出现的神经后遗症。诸如栓塞、缺氧、脑灌注不足和生化紊乱等并发症都可能导致心脏手术后脑损伤。术后急性神经问题包括癫痫发作、意识水平受损、局灶性运动功能缺损和运动障碍。长期后遗症包括语言和学习障碍、智力迟钝、癫痫发作和脑瘫。术中脑监测技术目前尚不完善，但将其与细致的术中及术后护理相结合，是目前降低神经发病率的最佳方法。未来的研究应探索其他方法，以保护接受心脏直视手术儿童的神经完整性。
