上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

非体外循环冠脉搭桥患者术后认知功能障碍的相关因素分析

赵嫣红1，闻大翔2   

  1. 上海交通大学 医学院 1.附属国际和平妇幼保健院麻醉科， 上海 200030； 2.附属仁济医院麻醉科， 上海 200127
  • 出版日期:2016-01-28 发布日期:2016-02-26
  • 通讯作者: 闻大翔, 电子信箱: wdxrwj@126.com。
  • 作者简介:赵嫣红（1984—)， 女， 主治医师， 硕士; 电子信箱: juicy_hong@hotmail.com。

Analysis of related factors of postoperative cognitive dysfunction for patients undergoing off-pump coronary artery bypass graft surgery

ZHAO Yan-hong1, WEN Da-xiang2   

  1. 1.Department of Anesthesiology, International Peace Maternity and Child Health Hospital， Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China； 2.Department of Anesthesiology, Renji Hospital， Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
  • Online:2016-01-28 Published:2016-02-26

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摘要：

目的 研究非体外循环冠脉搭桥（OPCABG）患者术后认知功能障碍（POCD）的发生率及相关因素。方法 对上海交通大学医学院附属仁济医院72例OPCABG患者应用简易智能量表进行术后认知功能评定，采集患者既往病史及围术期一般情况进行相关因素分析。结果 OPCABG患者早期POCD的发生率为27.8%。其相关影响因素包括术前糖尿病病史（P=0.031）、围术期高血糖（P=0.034）、术前脑梗病史（P=0.044），均具有统计学意义。结论 OPCABG患者早期POCD的发生率较高，其可能的相关因素包括糖尿病病史、围术期高血糖、脑梗史等。积极的术前干预治疗、合适的血糖维持、良好的术后处理均对预防患者POCD的发生具有重要的临床意义。

关键词: 非体外循环冠脉搭桥术, 术后认知功能障碍, 发生率, 相关因素

Abstract:

Objective To explore the incidence and related factors of postoperative cognitive dysfunction (POCD) of patients undergoing off-pump coronary artery bypass graft surgery (OPCABG). Methods Seventy two patients undergoing OPCABG in Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine were enrolled. The POCD of patients was assessed by mini-mental state examination. Previous medical histories and perioperative information of patients were collected and related factors were analyzed.  Results The incidence of early POCD of patients undergoing OPCABG was 27.8%. Related influencing factors include history of diabetes (P=0.031), perioperative hyperglycemia (P=0.034), and history of cerebral infarction (P=0.044), which were all statistically significant. Conclusion The incidence of early POCD of patients undergoing OPCABG is high. Related influencing factors may include history of diabetes, perioperative hyperglycemia, and history of cerebral infarction, etc. Active preoperative intervention, maintenance of a proper blood glucose level, and good postoperative treatment are clinically significant for the prevention of POCD.

Key words: off-pump coronary artery bypass graft surgery, postoperative cognitive dysfunction, incidence, related factors