摘要
目的探讨体外循环心脏手术对婴幼儿期患儿中枢神经系统的影响。方法 3岁以下先天性心脏病患儿30例,分为非紫绀组(n=14)和紫绀组(n=16),进行心脏手术。将两组患儿的临床资料和不同时点血S-100β蛋白和神经元特异性烯醇化酶(NSE)浓度进行比较。结果紫绀组患儿主动脉阻断和体外循环时间比非紫绀组长(P<0.05);两组患儿术后即刻S-100β浓度比术前高(P<0.05),组间比较差异无统计学意义(P>0.05);非紫绀组患儿NSE术后所有时点比术前高(P<0.05),紫绀组患儿术后6、24h比术前高(P<0.05),组间比较差异无统计学意义(P>0.05)。术后即刻S-100β浓度峰值与清醒时间(r=0.452,P<0.05)、机械通气时间(r=0.450,P<0.05)呈正相关;术后即刻NSE浓度峰值与主动脉阻断时间(r=0.462,P<0.05)呈正相关。术后随访,所有患儿智力正常,生长发育良好。结论婴幼儿心脏手术,对中枢神经系统有一定影响,这些影响多为可逆的;在法洛四联症和室间隔缺损伴肺动脉高压患儿之间没有明显差别。
Objective To investigate the effects of cardiac surgery with cardiopulmonary bypass on central nervous system in infants.Methods Thirty children younger than 3 year old with congenital heart diseases were enrolled and assigned into non-cyanosis group（ventricular septal defect with pulmonary hypertension）and cyanosis group（tetralogy of Fallot）.Concentrations of S100β and NSE in blood sample from jugular vein were measured after operation.Results The durations of CPB and postoperative hospitalization in non-cyanosis group were significantly shorter than those in the other group（P0.05）.The concentration of S-100β 0 hour after operation was significantly higher than baseline in both groups（P0.05）.There was no significant difference in the concentration of S-100β between non-cyanosis group and cyanosis group（P0.05）.The concentrations of NSE at all time points after operation were significantly higher comparing with baseline in non-cyanosis group,and increased at 6 hour and 24 hour after operation in cyanosis group（P0.05）.However,there was no significant difference in concentration of NSE between the two groups（P0.05）.Positive correlations were shown between the peak value of S-100β and the durations of waking and ventilation.Furthermore,there was positive correlation between the peak value of NSE and the duration of aorta across-clamping.Conclusion Although cardiopulmonary bypass cardiac surgery affects on central nervous system in infants,most of the effects are reversible.There is no difference between non-cyanosis group and cyanosis group in the effects.
出处
《广东医学》
CAS
CSCD
北大核心
2010年第16期2080-2082,共3页
Guangdong Medical Journal
基金
广东省医学科研基金资助项目(编号:A2009047)
关键词
心脏手术
脑保护
婴幼儿
infant
cardiac surgery
brain protection
