心脏直视手术中的脑保护
Cerebral protection during open-heart surgery.
作者信息
Aberg T, Kihlgren M
出版信息
Thorax. 1977 Oct;32(5):525-33. doi: 10.1136/thx.32.5.525.
Abstract
To reduce the incidence of cerebral damage after open-heart surgery measures were undertaken based on physiological principles and consideration of the possible injury caused by microemboli. Intellectual function was measured by psychometric tests before and after operation. The results were compared with those of an earlier series. There was a striking reduction in the incidence of neurolocial complications. There was also a considerable reduction in the degree of impairment of intellectual function previously shown to develop after open-heart surgery. However, there are still signs that cardiopulmonary bypass brings about subclinical cerebral injuriies. The measures taken and their rationale are discussed. Psychometric testing is a useful method for evaluating the quality of cardiopulmonary bypass as it allows a quantitative assessment of postoperative cerebral function.
摘要
为降低心脏直视手术后脑损伤的发生率，基于生理学原理并考虑微栓子可能造成的损伤采取了相应措施。术前和术后通过心理测量测试来评估智力功能。将结果与早期系列研究的结果进行比较。神经并发症的发生率显著降低。心脏直视手术后先前出现的智力功能损害程度也有相当程度的减轻。然而，仍有迹象表明体外循环会导致亚临床脑损伤。文中讨论了所采取的措施及其基本原理。心理测量测试是评估体外循环质量的一种有用方法，因为它可以对术后脑功能进行定量评估。
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本文引用的文献
1
Neuropathological manifestations of cardiac surgery.心脏手术的神经病理学表现
Ann Thorac Surg. 1969 May;7(5):409-19. doi: 10.1016/s0003-4975(10)66203-0.
2
Effects of extracorporeal circulation upon behavior, personality, and brain function. II. Hemodynamic, metabolic, and psychometric correlations.体外循环对行为、人格和脑功能的影响。II. 血流动力学、代谢和心理测量学的相关性。
Ann Surg. 1971 Jun;173(6):1013-23. doi: 10.1097/00000658-197106010-00020.
3
Clinical use of a dacron wool filter during perfusion for open-heart surgery.
J Thorac Cardiovasc Surg. 1970 Oct;60(4):575-81.
4
Central nervous system dysfunction following open-heart surgery.心脏直视手术后的中枢神经系统功能障碍。
JAMA. 1970 May 25;212(8):1333-40.
5
Changes in the filtration characteristics of stored blood.
Ann Surg. 1970 Mar;171(3):329-35. doi: 10.1097/00000658-197003000-00002.
6
The production of microemboli by various blood oxygenators.
Ann Thorac Surg. 1970 Mar;9(3):221-8. doi: 10.1016/s0003-4975(10)65494-x.
7
Neurological abnormalities following open-heart surgery.
J Thorac Cardiovasc Surg. 1969 Oct;58(4):502-9.
8
Psychiatric complications following cardiac surgery. I. A review article.心脏手术后的精神并发症。I. 一篇综述文章。
J Thorac Cardiovasc Surg. 1966 Mar;51(3):307-19.
9
Long-term effects of open-heart surgery on intellectual functioning.心脏直视手术对智力功能的长期影响。
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