脑卒中后非体外循环下冠状动脉旁路移植术后神经系统并发症研究

Neurological complication after off-pump coronary artery bypass grafting in patients with stroke

目的:研究既往脑卒中病史与非体外循环下冠状动脉旁路移植术(off-pump coronary arterybypass grafting,OPCABG)后神经系统并发症(neurological complication,NC)的相关性。方法:收集2010年7月至2012年7月间,住院行OPCABG的患者469例,其中既往有脑卒中病史患者为病例组共69例,无脑卒中病史患者为对照组共400例,对比研究术后7d的NC发病率。结果:术后NC总发病率为22.0%(103/469),既往有脑卒中病史患者NC发病率明显高于无脑卒中病史患者(36.2%vs.19.5%,P=0.002)。病例组年龄、高血压患病率高于对照组(P<0.005)。Logistic多因素回归分析显示,脑卒中病史(OR=2.172,95%CI:1.076～4.385,P=0.030)、颈部血管狭窄(OR=1.751,95%CI:1.019～3.009,P=0.042)为OPCABG术后NC的独立危险因素。结论:既往脑卒中患者OPCABG术后NC发病率明显高于无脑卒中患者,脑卒中病史、颈部血管狭窄为OPCABG术后NC发生的危险因素。

Objective：To investigate neurological complication（NC） after off-pump coronary artery bypass grafting（OPCABG） in the patients with and without stroke history.Methods： 469 patients who would do OPCABG from July 2010 to July 2012 were collected.The number of case group who suffered stroke is 69.And the number of control group is 400.The risk factors of NC after a week of OPCABG are studied between the groups.Results： The morbidity of NC is 22.0%.The morbidity of case group is higher than control group（36.2% vs.19.5%,P=0.002）.Age and hypertension are higher in case group than control group（P0.005）.Stroke history（OR=2.172,95%CI：1.076~4.385,P=0.030） and the stenosis of extracranial carotid arteries（OR=1.751,95%CI：1.019~3.009,P=0.042） are the risk factors of NC after one week of OPCABG.Conclusion： The morbidity of patients with stroke is higher than the patient without stroke.The risk factors are stroke history and the stenosis of extracranial carotid arteries.