Fallon P, Aparício J M, Elliott M J, Kirkham F J
Neurosciences Unit, Institute of Child Health, London.
Arch Dis Child. 1995 May;72(5):418-22. doi: 10.1136/adc.72.5.418.
A total of 523 cardiac surgical discharge summaries were searched for recorded evidence of adverse neurological events occurring between operation and time of discharge. Neurological events were recorded in 31 and included one or more of seizure disorder (n = 16), pyramidal signs (n = 11), extrapyramidal signs (n = 8), coma (n = 6), and neuro-ophthalmic deficits (n = 6). There were significantly more adverse neurological events after repairs for arch anomalies (16.6% of cases). There was also an association with the length of cardiopulmonary bypass and a period of low perfusion pressure either intraoperatively or postoperatively. Of the 19 out of 23 survivors in whom long term outcome data were available, four were normal and six had persisting neurological problems directly related to the perioperative period. In a further nine of the 19 survivors, established preoperative neurodevelopmental abnormality probably contributed to their present neurological status, in addition to perioperative events. In view of the way these data were collected, this study must represent the minimum incidence of neurological events in children undergoing cardiac surgery.
共检索了523份心脏外科出院小结，以寻找手术至出院期间发生不良神经事件的记录证据。记录到31例神经事件，包括癫痫发作障碍（n = 16）、锥体束征（n = 11）、锥体外系征（n = 8）、昏迷（n = 6）和神经眼科缺陷（n = 6）中的一种或多种。在修复主动脉弓畸形后，不良神经事件明显更多（占病例的16.6%）。还发现与体外循环时间以及术中或术后的低灌注压期有关。在有长期结局数据的23名幸存者中的19名中，4名正常，6名有与围手术期直接相关的持续性神经问题。在这19名幸存者中的另外9名中，除围手术期事件外，术前已确定的神经发育异常可能导致了他们目前的神经状态。鉴于这些数据的收集方式，本研究必定代表了接受心脏手术儿童神经事件的最低发生率。
