Ohnishi Y, Uchida O, Hayashi Y, Kuro M, Sugimoto K, Kuriyama Y
Department of Anesthesiology, National Cardiovascular Center, Suita.
Masui. 1995 Oct;44(10):1327-33.
We studied the relationship between quantity of microbubble retained in the left heart and neuropsychologic alterations after surgery in 21 patients undergoing cardiac surgery including cardiopulmonary bypass. The neuropsychologic change was evaluated by three kinds of psychological test, which mainly analyzed memory and cognition. The microbubble was continuously monitored by the long axis view of the descending aorta of transesophageal echocardiography and then quantitatively analyzed and graded by the on-line computer. More microbubbles were detected in the valve surgery requiring the intracardiac procedure than in coronary artery bypass grafting and neuropsychologic deterioration, although the relationship did not reach statistical significance. Since most of the microbubbles were detected during the unclamping of aorta and the weaning from cardiopulmonary bypass, a technical improvement of the surgical procedures could reduce them. We think that transesophageal echocardiography is useful for monitoring microbubbles during operation.
我们研究了21例接受包括体外循环在内的心脏手术患者左心内留存微泡数量与术后神经心理改变之间的关系。通过三种心理测试评估神经心理变化，主要分析记忆和认知。通过经食管超声心动图降主动脉长轴视图持续监测微泡，然后由在线计算机进行定量分析和分级。与冠状动脉搭桥术相比，需要心内操作的瓣膜手术中检测到的微泡更多，且存在神经心理恶化情况，尽管这种关系未达到统计学意义。由于大多数微泡是在主动脉松开和体外循环撤机期间检测到的，手术操作的技术改进可以减少微泡。我们认为经食管超声心动图在手术期间监测微泡方面很有用。
