心脏停跳与不停跳心内直视手术患者围手术期EEG变化的比较

目的　观察浅低温体外循环 (CPB)心脏不停跳与中浅低温体外循环心脏停跳心内直视手术患者 ,手术前后的脑电图(EEG)变化 ,探讨心脏不停跳技术对脑功能的影响。方法　选择接受择期心内直视手术患者 5 2例 ,分为A组 (n1 =2 6 ) ,在中浅低温体外循环心脏停跳下施行开心手术 ;B组 (n2 =2 6 ) ,在浅低温体外循环心脏不停跳下施行手术。两组患者术前进行脑电图检查 ,无脑电图明显异常者 ,术后 7d复查EEG ,比较分析两组术后EEG检查结果。结果　两组患者术后 1周EEG的异常率A组6 5 .4 % ,B组 6 9.2 % ,较术前明显变差 (P <0 .0 1 ) ;但两组间差异不显著 (P >0 .0 5 ) ;接受开心手术的先心病患者手术后EEG的异常率较风心病患者术后EEG的异常率高 (P <0 .0 5 )。结论　采用本院改进的心脏不停跳心内直视手术方法与常规心脏停跳心内直视手术相比没有增加对脑组织的损伤程度 ;开心手术对小儿先天性心脏病患者脑组织的影响较成人风湿性心脏病患者重

Comparison of the EEG changes in traditional arrested-heart and on-pump beating-heart intracardiac procedures

Objective To evaluate comparatively the changes of the EEG in arrested heart and on pump beating heart intracardiac procedures.Methods Fifty two patients were randomly divided into two groups: control group(group A, n =26) and experimental group(group B, n =26). The patients in group A were undergone in traditional arrested heart intracardiac procedures, the patients in group B undergone in beating heart procedures. All patients were checked EEG before and 6 days after operation.The EEG changes with the two groups were compared.Results The EEG abnormality rate of postoperation was significantly higher than the preoperation's( P <0.01). Abnormality rate was 65.4% in group A, and 69.2% in group B. There was no significant difference of EEG abnormality rate between the two groups one week after operation. The EEG abnormality rate of postoperation in group CHD was higher than in group RHD( P <0.05). Conclusion Our modified on pump beating heart intracardiac procedures don't make more serious cerebral dysfunction than the traditional arrested heart intracardiac procedures. Intracardic procedures make more effect to cerebral function in CHD than in RHD.