体外循环后脑栓塞和继发中枢神经功能不全

Cerebral Microemblism with Secondary Dysfunction of the Central Nervons System Following Cardiopulmonary Bypass.

神经功能障碍是开心手术后常见的并发症,往往由于微栓引起局灶性、缺血性脑损害所致。本文报导了三年来遇到的7例心内直视手术后发生脑栓塞遗留严重脑损害病例。除一例在体外循环期间发生泵管脱落外,余6例的麻醉、体外循环和心肺复苏都无太大难度。病员均在术毕2小时一度苏醒,但不久后即出现脑缺氧抽搐及左侧肢体瘫痪等症状。本文回顾了最易引起脑栓塞的几个关键步骤,并讨论了可行的监测、预防和治疗措施。

Impairment of neural function is common following open heart surgery.The complicationis often caused by microembolic events,which produce focal ischemic brain injury. Seven cases of subsequent cerebral dysfunction caused by microembolism following open heant surgery in past three years are reported in this article.No complications occured during the anesthesia and cardiopulmonary bypass was discontinued without difficulty except for one case in which the external line was once disconnected.After the surgery all patients gained consciousness but after a few hours cerebral anoxia with convulsions and left hemiplegia occurred Important steps in which cerebral embolism most trequently occurred were reviewed.The possible methods of surreillance,the prevention and the management were also discussed