摘要
目的:通过分析体外循环与非体外循环心脏外科手术后脑梗死的临床及影像学特点,探讨其发病机制。方法:将心脏外科手术术后脑梗死患者45例分为非体外循环与体外循环2组。非体外循环组30例,体外循环组15例。比较2组术后脑梗死临床及影像学特点。结果:非体外循环组拔管时间及ICU时间明显短于体外循环组〔P<0.05,(22.8±16.6)h与(50.9±32.6)h,(25.6±14.0)h与(52.6±30.0)h〕;非体外循环组早发脑梗死、大面积脑梗死及双侧脑梗死的发生率明显低于体外循环组(P<0.05,6.7%与40.0%,21.7%与64.3%,4.4%与35.7%);非体外循环组皮层脑梗死的发生率43.5%明显高于体外循环组的7.1%(P<0.05);2组分水岭脑梗死及多发脑梗死的发生率均较高。结论:体外循环手术后易发生早发脑梗死,常为双侧与大面积脑梗死,症状较重;非体外循环手术后脑梗死常为迟发脑梗死,皮层梗死较多;2者分水岭梗死均较多。说明2者脑梗死的发病机制不同,但均与栓塞和低灌注有关。
Objective：To analyse the clinic and imaging characteristics in patients with cerebral infarcts after cardiac surgery.Methods：45 patients with cerebral infarcts after cardiac surgery were divided into two groups：30 patients in off-pump group and 15 patients in on-pump group.Preoperative,postoperative and imaging characteristics were compared in the two groups.Results：The on-pump group took longer to extubate and stay in ICU than the off-pump group〔P 0.05,（50.9 ± 32.6） h vs（22.8 ± 16.6） h and（52.6 ± 30.0） h vs（25.6 ±14.0） h）〕.The incidence of early stroke,large territorial infarct and bilateral infarct after surgery in the off-pump group was lower than those in on-pump group（P 0.05,6.7% vs 40.0%,21.7% vs 64.3% and 4.4% vs 35.7%）.The incidence（43.5%） of pial infarct in off-pump was higher than those（7.1%） in onpump group.The incidence of border zone infarct and multiple infarct was higher in the two groups.Conclusion：On-pump surgery was associated with early stroke,large territorial infarct and bilateral infarct,whereas off-pump was associated with late stroke and pial infarct;it is suggested that the mechanisms of infarct after cardiac surgery might be different in the groups,but was associated with hypotension and embolism.
出处
《心肺血管病杂志》
CAS
2010年第2期108-111,共4页
Journal of Cardiovascular and Pulmonary Diseases
