心血管手术后早期神经精神并发症的调查

Morbidity of Neuropsychiatric Disorder in the Early Postoperative Period after Cardiovascular Surgery

目的 :调查心血管手术后早期神经精神并发症的种类和总发病率。方法 :调查 16周岁以上患者 398例 ,其中先天性心脏病 82例 ,风湿性心脏病及瓣膜病 175例 ,冠心病 10 1例 ,大血管病 32例 ,心脏肿瘤 8例。女性 15 2例 ,男性 2 46例。以标准化临床神经功能检查法为主 ,必要时行计算机断层摄影术、脑电图等检查 ,评估心血管手术后早期患者的神经精神功能 ,于术前 1日进行 ,术后第 1日始每日随访 1次 ,至术后第 7日。结果 :术后第 1日神经精神功能障碍的总发病率为 35 4 %,术后第 7日内脑卒中的发病率为 5 3%,持续性脑病为 8 0 %,术后第 7日仍有 5 5 %遗留不同程度的功能障碍。结论 :心血管手术后早期神经精神障碍的发病率相当高 ,通过术后早期详尽的神经精神功能检查即可发现 ,应引起临床重视。

Objective:To investigate the morbidity of neuropsychiatric disorder in the early period after cardiovascular surgery. Methods:We performed standard neurologic examinations,including computer topography,elctroencephalogrphy in 398 patients (152 females and 246 males,age>16) undergoing cardiovascular surgery.The patients were examined 1 day before and 1-7 days after surgery. Results:The study population included 82 patients with congenital heart disease,175 with valves heart disease,101 with coronary artery disease,32 with major vascular disease and 8 with cardiac tumor.Our investigation demonstrated that the morbidity rates were 35.4% on the first day,and 5.5% on the 7th day after surgery.The major complications were stroke and prolonged encephalopathy (5.3% vs.8.0%). Conclusions:The morbidity of neuropsychiatric disorder following cardiovascular surgery is very high in the early postoperative period,which we should pay full attention to.We can find these abnormoalities by standard neurologic examinations.