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婴儿期采用低温和循环阻断进行心脏手术后的发育进展。

Developmental progress after cardiac surgery in infancy using hypothermia and circulatory arrest.

作者信息

Clarkson P M, MacArthur B A, Barratt-Boyes B G, Whitlock R M, Neutze J M

出版信息

Circulation. 1980 Oct;62(4):855-61. doi: 10.1161/01.cir.62.4.855.

Abstract

Seventy-two of 76 long-term survivors who had surgical repair of congenital heart lesions at 11 days to 26 months of age using profound hypothermia and circulatory arrest underwent psychometric testing (Stanford-Binet) late postoperatively. The mean IQ of the 72 patients was 92.9 +r16.5 (SD). Stanford-Binet scores bore no relationship to the duration of circulatory arrest or other aspects of surgical technique. Scores were significantly lower in those who had a low birth weight for gestational age, important neurologic problems preoperatively or were in the lower socioeconomic classes. An "ideal" control group of 69 children randomly selected from patients satisfying certain criteria based on birth and neonatal characteristics had a mean IQ of 106.2 +r11.6. Twenty-five patients who had surgical treatment of cogenital heart disease met the criteria for the control group except for their heart lesions. Their mean IQ was 101.4 +r15.0(NS). We could not demonstrate any significant deleterious effect that could be attributed to the surgical methods. Rather, the postoperative IQ scores reflected characteristics related to individual patients.

摘要

76名在11日龄至26月龄时采用深度低温停循环进行先天性心脏病变手术修复的长期存活者中,有72人在术后晚期接受了心理测量测试(斯坦福-比奈智力量表)。这72名患者的平均智商为92.9±16.5(标准差)。斯坦福-比奈智力量表得分与停循环时间或手术技术的其他方面无关。对于那些出生体重低于孕周、术前有重要神经系统问题或社会经济阶层较低的患者,得分显著较低。从根据出生和新生儿特征满足某些标准的患者中随机选取的69名儿童组成的“理想”对照组,平均智商为106.2±11.6。25名接受先天性心脏病手术治疗的患者除心脏病变外符合对照组标准。他们的平均智商为101.4±15.0(无显著性差异)。我们无法证明手术方法会产生任何显著的有害影响。相反,术后智商得分反映了与个体患者相关的特征。

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