心脏术后发生脑损伤的危险因素分析

目的通过分析心脏术后反应脑功能损害的指标神经特异性烯醇（NSE）与术前、术后各个因素的相关性，探寻导致心脏术后发生脑损伤的危险因素。方法相关分析采用Spearman相关方法，分析心脏术后反应脑功能损害的指标NSE与术前、术后各个因素的相关性。结果心脏术后NSE水平与气管插管时间（r=0.366，P=0.001）、术前氧合指数（r=0.921，P=0.011）、术前ALT有相关性（r=0.193，P=0.008）、术后1 h血肌酐水平（r=0.188，P=0.005）、术后第1天血肌酐水平（r=0.407，P=0.001）、术后第2天血肌酐水平（r=0.370，P=0.001）及术后第3天血肌酐水平（r=0.324，P=0.003）呈正相关，与术后12 h氧合指数（r=?0.421，P<0.01）呈负相关关系。结论术前氧合指数下降、肝功能不全、术后12 h缺氧、术后出现肾功能障碍、年龄、术前心功能不全是心脏术后发生脑损伤的危险因素。 

Brain injury after cardiac surgery

ObjectiveTo explore the relevant factors of postoperative brain damage by analyzing the correlation between NSE and preoperative and postoperative factors.MethodsSpearman correlation method was used to analyze the correlation between neuron specific enolase NSE with various preoperative and postoperative factors.ResultThe concentration of NSE was related to intubation time (P=0.001, r=0.366), preoperative and 12 h after operation oxygenation index (P<0.01), preoperative ALT (P=0.008, r=0.193) and postoperative creatinine.ConclusionThe preoperative and 12 h after operation oxygenation index fell, hepatic insufficiency, postoperative renal dysfunction, age and cardiac dysfunction are the risk factors for brain damage after cardiac surgery. The preoperative renal insufficiency, postoperative liver function, CBP and aortic clip time are not risk factors for brain damage after cardiac surgery.