心脏手术后早期脑血管病并发症的临床研究

目的 探讨心脏手术后脑血管病并发症的发生、死亡、种类、危险因素以及防治方法。方法 回顾分析了１０１７３例心脏手术后各种神经系统并发症的总发生率，重点统计脑血管病并发症的发生率、死亡率和种类，并与对照组进行比较分析。结果 心脏手术后神经系并发症的总发生率为１．４４％，其中脑血管病占５９．５８％。脑血管病并发症中脑栓塞占３９．０８％，脑血栓形成占２８．７４％，脑出血占１１．４９％，人造瓣膜心内膜感染并

Cerebrovascular diseases complications after cardiac surgery

Objective To assess morbidity, mortality, sorts, risk factors, prevention and treatment of patients with cerebrovascular disease complication (CVDC) undergoing cardiopulmanary bypass (CPB). Methods We retrospectively reviewed 10 173 cases of CPB surgery, analysed risk factors of CVDC after CPB surgery in comparison with controls. Results After CPB surgery, the general morbidity of neurological complications (NC) was 1.44% (146/10 173), of which CVDC accounted for 59.58% (87/146). In the CVDC group, cerebral embolism accounted for 39.09%, cerebral infarction 28.74%, cerebral haemorrhage 11.49%, prosthetic valve endocarditis (PVE) with CVD 10.34%, and others 10.35%. Death occurred in 44 patients of the NC group, in which CVDC went to 47.72% (21/44). Aortic clump time and CPB time were greatly longer in the CVDC group than controls ( P <0.01). Conclusions The main postoperative neurological complications after CPB surgery are CVDC, most of which are ischemic cerebrovascular disease. Postoperative CVDC correlates with longer aortic clump time and CPB time during the operation.