持续流动的细胞节约剂减少了冠状动脉旁路手术后老年患者的认知衰退
George Djaiani1, Ludwik Fedorko, Michael A Borger
1Department of Anesthesia, Toronto General Hospital, University Health Network, 200 Elizabeth St, Toronto, Ontario, M5G 2C4, Canada. george.djaiani@uhn.on.ca
Circulation
|October 10, 2007
概括
使用细胞节约器处理流血可显著减少心脏手术后的认知衰退. 这种方法限制了脂质微粒,这是术后认知功能障碍的关键因素.
科学领域:
- 心血管外科心血管外科
- 神经科学是一个神经科学.
- 输血医学 输血医学
背景情况:
- 心肺旁路可以导致大脑微栓塞,导致心脏手术后的认知能力下降.
- 未经加工的流血,是脂质微粒的来源,在心肺绕道术期间输血.
- 流血的细胞节约处理可以减轻大脑微栓塞.
研究的目的:
- 评估细胞节约处理在心脏手术后减少认知衰退的有效性.
- 研究脂质微粒在术后认知功能障碍中的作用.
主要方法:
- 226名老年患者被随机分为细胞节约器和对照组.
- 脑栓塞率使用跨骨多普勒监测.
- 神经心理测试评估了手术前和手术后6周的认知功能.
主要成果:
- 认知功能障碍发生在细胞节约组的6%,对照组的15% (P=0.038).
- 大动脉动脉瘤的严重程度和脑栓塞数量在两组之间是可比的.
- 主要结局表明,使用细胞节约器显著减少了认知功能障碍.
结论:
- 使用细胞节约器处理流血可显著减少术后认知功能障碍.
- 脂质栓塞在临床上很重要,因为它有助于心肺旁路术后认知能力下降.
- 细胞节约技术为改善心脏手术患者认知结果提供了一个潜在的策略.
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