Objective: To assess the cerebral injury in on-pump beating-heart procedures under mild hypothermia in comparison with traditional on-pump arrested-heart procedures under moderate hypothermia. Methods: Forty patients,...Objective: To assess the cerebral injury in on-pump beating-heart procedures under mild hypothermia in comparison with traditional on-pump arrested-heart procedures under moderate hypothermia. Methods: Forty patients, 20 with congenital heart disease (CHD) and 20 of rheumatic heart disease (RHD) , were divided into 2 groups: Control group (group A, n =20) including 10 patients suffering from CHD as group Al and the left 10 from RHD as group A2; and experiment group (group B, n =20) which consisting of group B1 (10 with CHD) and group B2 (10 of RHD). The patients in group A underwent traditional arrested-heart procedures, and those in group B were operated on with beating-heart procedures. Arterial blood samples were collected at preoperation (time A) , 20 min after cardiopul-monary bypass (CPB) starting (time B) , 1 h after CPB (time C) and 24 h postoperation (time D) respectively. Plasma contents of neuron-specific enolase (NSE) and protein S-100b were measured with sensitive ELISA. All the patients received echoencephalography (EEG) before and 1 week after operation. Results: The plasma contents of protein S-lOOb were increased very significantly at time B, C and D in comparison with those at time A (P<0.01) , and that of patients in group Al was significantly higher than that in group B at time B (P < 0. 05 ). There was no significant difference at other time points. At time B, the plasma contents of NSE were significantly higher in group A than in group B, and in group Al and Bl than in group A2 and B2. What's more, at time B, the former fell back to their pre-operative levels, but the latter remained still higher levels than the preoperative ones ( P < 0.01). No significant difference was found in the abnormality rates of postoperative EEG between 2 groups. Conclusion: The perioperative plasma contents of NSE and protein S-100b are not significantly higher in group B than in group A. On-pump beating-heart procedures do not make more serious cerebral dysfunction than the traditional arrested-heart procedures.展开更多
文摘Objective: To assess the cerebral injury in on-pump beating-heart procedures under mild hypothermia in comparison with traditional on-pump arrested-heart procedures under moderate hypothermia. Methods: Forty patients, 20 with congenital heart disease (CHD) and 20 of rheumatic heart disease (RHD) , were divided into 2 groups: Control group (group A, n =20) including 10 patients suffering from CHD as group Al and the left 10 from RHD as group A2; and experiment group (group B, n =20) which consisting of group B1 (10 with CHD) and group B2 (10 of RHD). The patients in group A underwent traditional arrested-heart procedures, and those in group B were operated on with beating-heart procedures. Arterial blood samples were collected at preoperation (time A) , 20 min after cardiopul-monary bypass (CPB) starting (time B) , 1 h after CPB (time C) and 24 h postoperation (time D) respectively. Plasma contents of neuron-specific enolase (NSE) and protein S-100b were measured with sensitive ELISA. All the patients received echoencephalography (EEG) before and 1 week after operation. Results: The plasma contents of protein S-lOOb were increased very significantly at time B, C and D in comparison with those at time A (P<0.01) , and that of patients in group Al was significantly higher than that in group B at time B (P < 0. 05 ). There was no significant difference at other time points. At time B, the plasma contents of NSE were significantly higher in group A than in group B, and in group Al and Bl than in group A2 and B2. What's more, at time B, the former fell back to their pre-operative levels, but the latter remained still higher levels than the preoperative ones ( P < 0.01). No significant difference was found in the abnormality rates of postoperative EEG between 2 groups. Conclusion: The perioperative plasma contents of NSE and protein S-100b are not significantly higher in group B than in group A. On-pump beating-heart procedures do not make more serious cerebral dysfunction than the traditional arrested-heart procedures.
