体外循环心内直视手术对患者颅内血浆NSE水平影响因素分析

An investigation on risk factors of cerebral venous blood NSE levels after CPB for open heart surgery

目的分析体外循环心内直视手术后患者颅内血浆NSE水平的影响因素,提高心内直视手术后患者神经系统并发症的诊治水平。方法择期心内直视手术患者21例,在CPB结束后30 min采集颈内静脉球部血液检测NSE水平,并用多因素线性回归分析模型评价各影响因素的作用大小。结果体外循环后神经系统并发症的相关危险因素包括患者年龄、体外循环时间和颅内血浆MDA浓度。结论在体外循环心内直视手术的临床监测指标中,患者的年龄、体外循环时间和颅内血浆MDA水平与术后神经系统并发症的发生高度相关。

Objective To analyze the risk factors of cerebral venous blood NSE levels after CPB for open heart surgery and to improve the management for the patients undergoing CNS complications. Methods 21 consecutive patients, who were classified into ASA physical status 2 or 3 and scheduled for elective cardiac surgery were included in the study. Patients with history of hypertension, cerebral diseases and endocrine system diseases were excluded. Catheters were placed in the left jugular bulb for sampling of jugular bulb venous blood. Blood samples were collected simultane- ously for determination of NSE level after CPB 30 minutes. And the multivariate liner regress analysis model was used to evaluate the influence of the variables. Results Multivariate liner regress analysis showed that cerebral venous blood NSE levels after CPB for open heart surgery was related with the CPB time, the age of patients and the level of MDA. Conclusion This study shows the CPB time, the age of patients and the level of MDA are risk factors of NSE.